de Jonge, A.van der Goes, B.Ravelli, A.Amelink-Verburg, M.Mol, B.Nijhuis, J.Bennebroek Gravenhorst, J.Buitendijk, S.2014-10-172014-10-172009BJOG: an International Journal of Obstetrics and Gynaecology, 2009; 116(9):1177-11841470-03281471-0528http://hdl.handle.net/2440/86313Article first published online: 15 APR 2009Objective: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. Design: A nationwide cohort study. Setting: The entire Netherlands. Population: A total of 529 688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321 307 (60.7%) intended to give birth at home, 163 261 (30.8%) planned to give birth in hospital and for 45 120 (8.5%), the intended place of birth was unknown. Methods: Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics. Main outcome measures: Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit. Results: No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16). Conclusions: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.en© 2009 The AuthorsMidwifery; perinatal mortality; pregnancy outcomeJournal article002013687110.1111/j.1471-0528.2009.02175.x0002678797000062-s2.0-6824915214415286Mol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]