Accidental home deliveries in southern Sao Paulo, Brazil


de Almeida, MF; Alencar, GP; Novaes, MHD; Franca, I; Siqueira, AA; Schoeps, D; Campbell, O; Rodrigues, L; (2005) Accidental home deliveries in southern Sao Paulo, Brazil. Revista de saude publica, 39 (3). pp. 366-375. ISSN 0034-8910

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Abstract

Objective To identify the frequency, risks of fetal and early neonatal mortality and the determinants of accidental home deliveries. Methods A population-based case control study of fetal and early neonatal deaths was carried out in the southern area of Sao Paulo, Brazil. Data were collected through home interviews and hospital record reviews. The reasons reported by the mothers were obtained from interviews and risk factors for home delivery were obtained comparing home to hospital deliveries. Data were analyzed separately for fetal and early neonatal deaths and survivors. Odds ratios, 95% confidence intervals and Fisher exact test were used in estimating risk factors and mortality risk. Results The 0.2% frequency of home deliveries was underestimated in the live births information system. After adjustment, it reached 0.4%, comparable to other urban areas in Europe. All home deliveries identified were accidental and were associated to an increased fetal and early neonatal mortality. Mothers' social conditions and pregnancy characteristics were associated to accidental home deliveries and these factors are different outcomes studied (fetal losses, early neonatal deaths and survivors). In 30%, mothers reported lack of available transportation to the hospital as a reason for home delivery Failure of health services in identifying labor women and non-availability of emergency care contributed to accidental home deliveries. Conclusions Though rare events in urban areas, accidental home deliveries should be of special concern to health services because they seem to be avoidable and imply in increased risk of death.

Item Type: Article
Keywords: accidental home deliveries, fetal mortality, neonatal mortality, socio-economic factors, health service access, HOSPITAL BIRTHS, MORTALITY, SAFE
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Web of Science ID: 231562700006
URI: http://researchonline.lshtm.ac.uk/id/eprint/1267717

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