Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting

Levene, Malcolm I.; Chervenak, Frank A; Arabin, Birgit; Grunebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L

doi:10.1016/j.ajog.2013.06.025

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Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting

Author(s): Amos Grünebaum , Laurence B. McCullough , Katherine J. Sapra , Robert L. Brent , Malcolm I. Levene , Birgit Arabin , Frank A. Chervenak

Publication date Created: October 2013

Publication date (Print): October 2013

Journal: American Journal of Obstetrics and Gynecology

Publisher: Elsevier BV

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Abstract

To examine the occurrence of 5-minute Apgar scores of 0 and seizures or serious neurologic dysfunction for 4 groups by birth setting and birth attendant (hospital physician, hospital midwife, free-standing birth center midwife, and home midwife) in the United States from 2007-2010.

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The reliability and validity of birth certificates.

Sally Northam, Thomas Knapp (2016)

To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement. A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done. Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment. Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable. The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery. Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented.

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Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

Jacquelyn Blackstone, F. Lucas, Mathieu Pinette … (2010)

We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated. Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates. Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate. Copyright 2010 Mosby, Inc. All rights reserved.

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Life-table analysis of the risk of perinatal death at term and post term in singleton pregnancies.

Gordon C. S. Smith (2001)

This study was undertaken to estimate the cumulative risk of perinatal death associated with delivery at each gestational week both at term and post term. The numbers of antepartum stillbirths, intrapartum stillbirths, neonatal deaths, and surviving neonates delivered at between 37 and 43 weeks' gestation in Scotland, 1985-1996, were obtained from national databases (n = 700,878) after exclusion of multiple pregnancies and deaths caused by congenital abnormality. The numbers of deaths at each gestational week were related to appropriate denominators: antepartum stillbirths were related to ongoing pregnancies, intrapartum stillbirths were related to all births (excluding antepartum stillbirths), and neonatal deaths were related to live births. The cumulative probability of perinatal death associated with delivery at each gestational week was estimated by means of life-table analysis. The gestational week of delivery associated with the lowest cumulative risk of perinatal death was 38 weeks' gestation, whereas the perinatal mortality rate was lowest at 41 weeks' gestation. The risk of death increased more sharply among primigravid women after 38 weeks' gestation because of a greater risk of antepartum stillbirth. The relationships between risk of death and gestational age were similar for the periods 1985-1990 and 1991-1996. Delivery at 38 weeks' gestation was associated with the lowest risk of perinatal death.