What do the latest data reveal about the safety of home birth in the United States?

Planned home birth was associated with a significantly greater likelihood of a 5-minute Apgar score less than 4, compared with hospital birth (0.37% vs 0.24%, respectively; adjusted odds ratio [aOR], 3.08; 95% confidence interval [CI], 1.36–2.58), as well as a greater likelihood of neonatal seizures (0.06% vs 0.02%, respectively; aOR, 3.08; 95% CI, 1.44–6.58), according to this retrospective cohort study. The investigators note that an Apgar score of 0 to 3 at 5 minutes is a valid predictor of neonatal death.

Admission to a neonatal intensive care unit (NICU) was lower among infants born at home, compared with hospital delivery (aOR, 0.23%; 95% CI, 0.18–0.30).

Cheng YW, Snowden JM, King TL, Caughey AB. Selected perinatal outcomes associated with planned home births in the United States. Am J Obstet Gynecol. 2013;209(4):325.e1–e8. doi: 10.1016/j.ajog.2013.06.022.