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Table 3 Association between initial preferred birth setting and intrapartum interventions and maternal outcomes

From: The influence of preferred place of birth on the course of pregnancy and labor among healthy nulliparous women: a prospective cohort study

 

Midwife-led care

Obstetrician-led care

OR (adjusted)a

OR (adjusted)a

OR (adjusted)a

(95% CI)

(95% CI)

(95% CI)

Interventions/maternal outcomes

Preferred home birth

Preferred hospital birth

n = 182 (%)

Preferred MFL home birth vs. Preferred MFL hospital birth

Preferred MFL home birth vs. Preferred OBL hospital birth

Preferred MFL hospital birth vs. Preferred OBL hospital birth

n = 226 (%)

n = 168 (%)

Augmentation of labor

n = 192

n = 137

n = 120

   

 No

133 (69.3)

83 (60.6)

61 (50.8)

   

 Oxytocin or prostaglandins

59 (30.7)

54 (39.4)

59 (49.2)

0.79 (0.46 – 1.35)

0.54 (0.32 – 0.93)

0.69 (0.40 – 1.21)

Analgesia during labor

n = 215

n = 155

n = 160

   

 No

156 (72.6)

96 (61.9)

66 (41.3)

   

 Narcotic analgesia

25 (11.6)

33 (21.3)

35 (21.9)

0.56 (0.28 – 1.09)

0.41 (0.21 – 0.79)

0.74 (0.39 – 1.38)

 Epidural analgesia

34 (15.8)

26 (16.8)

59 (36.9)

0.94 (0.48 – 1.83)

0.32 (0.18 – 0.56)

0.34 (0.19 – 0.62)

Mode of birth

n = 216

n = 157

n = 162

   

 Spontaneous vaginal

161 (74.5)

104 (66.2)

103 (63.6)

   

 Assisted vaginal (VE/FE)

37 (17.1)

29 (18.5)

37 (22.8)

0.94 (0.49 – 1.83)

0.83 (0.45 – 1.53)

0.88 (0.46 – 1.68)

 Cesarean (unplanned)

18 (8.3)

24 (15.3)

22 (13.6)

0.48 (0.23 – 1.02)

0.75 (0.35 – 1.59)

1.55 (0.76 – 3.17)

Episiotomy

111 (56.3)

70 (51.9)

95 (68.3)

1.40 (0.86 – 2.29)

0.69 (0.44 – 1.10)

0.49 (0.30 – 0.81)

Perineum

n = 197

n = 135

n = 139

   

 Intact

39 (19.8)

23 (17.0)

20 (14.4)

   

 Tear

47 (23.9)

42 (31.1)

24 (17.3)

0.72 (0.41 – 1.26)

1.58 (0.87 – 2.87)

2.21 (1.18 – 4.12)

  First- or second degree tear

46

34

22

   

  Third- or fourth degree tear

1

8

2

   

Retained placenta

4 (2.0)

3 (2.2)

8 (5.7)

NT

NT

NT

Postpartum hemorrhage

n = 221

n = 160

n = 176

   

 <500 cc

158 (71.5)

108 (67.5)

109 (61.9)

   

 ≥500 - < 1000 cc

50 (22.6)

42 (26.3)

48 (27.3)

   

 ≥1000 cc

13 (5.9)

10 (6.3)

19 (10.8)

0.82 (0.32 – 2.08)

0.57 (0.25 – 1.30)

0.70 (0.30 – 1.63)

  1. aAdjusted for maternal age, method of conception, first pregnancy (previous miscarriage or ectopic pregnancy), gestational age at birth, medical indications pregnancy. OR = Odds Ratio; CI 95% = confidence interval 95%.
  2. MFL = Midwife-led; OBL = Obstetrician-led.