Posts Tagged ‘ Apgar score ’

Home Births Carry 10 Times the Risk of Stillborn Babies

Thursday, September 19th, 2013

A new study published in the American Journal of Obstetrics and Gynecology has found that women who give birth at home are 10 times more likely to have stillbirths; first-born children who are delivered at home are 14 times more likely to be stillborn.  More from ABC News:

In the largest study of its kind, investigators at New York-Presbyterian/Weill Cornell Medical Center in New York City reviewed data from a sampling of 13 million of the nearly 17 million singleton full-term births in the United States between 2004-2007. These included births to parents of all races, ethnic groups and income levels.

Among their findings: Babies born at home were nearly 10 times more likely to be stillborn, and the risk of stillbirth increased to 14 times for firstborns. Babies born at home were also almost four times more likely to experience neonatal seizures or serious neurologic dysfunction compared with babies born in hospitals.

The study’s results were confirmed by analyzing birth certificate files from the National Center for Health Statistics to evaluate deliveries by physicians and midwives in the hospital and at home from 2007 to 2010. The researchers looked at Apgars, scores that assess the health of an infant one minute and five minutes after birth. A five-minute Apgar score of zero is considered a stillbirth. About 10 percent of these babies survive, though often with major health problems.

“Childbirth is one of the most wonderful moments in humanity, and people deserve the best of all circumstances, including enhancing the experience and reducing unnecessary interventions,” said Dr. Amos Grunebaum, chief of labor and delivery at New York-Presbyterian/Weill Cornell Medical Center, and the study’s lead author. “Having said that, it’s not only about experience. It’s also about making sure the baby is born safely.”

Grunebaum said that the study associated risk with the location of a planned birth, rather than the credentials of the person delivering the baby. When a child is born at home, typically there is only the midwife or doctor to address any unpredictable circumstances that arise, but in the hospital, a team of specialists can be mobilized in seconds if needed, he said.

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Pitocin May Have Negative Effects on Newborns

Thursday, May 9th, 2013

The drug Pitocin, which is used to induce labor or keep labor going when it has slowed or stopped, has been found in a new study to have adverse effects on newborn babies.  The study, which was presented this week at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists, was the first to report a negative effect of the widely-used drug.

The study was based on data collected from 3,000 women who gave birth between 2009 and 2011.  The results showed that women who were given oxytocin (Pitocin is the most common brand name of this type of drug) were more likely to deliver babies who were unexpectedly admitted to the NICU after birth, and that those babies were more likely to remain in the NICU for more than 24 hours.  Babies born from Pitocin-augmented labors were also more likely to score less than 7 on the Apgar test, the standard test that evaluates a newborn’s physical condition at one and five minutes after birth based on appearance (skin coloration), pulse (heart rate), grimace response (medically known as “reflex irritability”), activity and muscle tone, and respiration (breathing rate and effort). An Apgar score of 8 or higher is generally regarded as the standard for a baby in good health.

Researchers insist that they are not advocating for Pitocin to be eliminated from the labor room, but instead that the drug should be used only when strongly indicated, not, for example, for an elective labor induction.

“We don’t want to discourage the use of Pitocin, but simply want a more systematic and conscientious approach to the indications for its use,” Dr. Michael S. Tsimis, the study’s primary investigator, said in a statement.

Image: Woman with IV in hospital, via Shutterstock

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