Evidence map›Paper›PMID 34773367›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2022

Maternal and neonatal outcomes following waterbirth: a cohort study of 17 530 waterbirths and 17 530 propensity score-matched land births.

M L Bovbjerg, M Cheyney, A B Caughey

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06429111 (Effectiveness and Safety in Maternal and Neonatal Outcomes of Waterbirth Compared to Delivery in Women Using Epidural Analgesia), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06429111 completednot on this map

Effectiveness and Safety in Maternal and Neonatal Outcomes of Waterbirth Compared to Delivery in Women Using Epidural Analgesia

TypeobservationalSponsorFundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat ValencianaRan2020 to 2023Enrolled642ConditionsNatural Childbirth, Water Birth, Neonatal Asphyxia, Outcome, Adverse BirthArmsEpidural analgesia, Immersion water
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 22 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Alternate Birth Strategies.International journal of women's health · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

M L BovbjergEpidemiology Program, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.ORCID https://orcid.org/0000-0003-2139-0549
M CheyneyDepartment of Anthropology, Oregon State University, Corvallis, OR, USA.
A B CaugheyDepartment of Obstetrics and Gynecology, Oregon Health & Science University, Corvallis, OR, USA.
Oregon State University · US

Funding

Home Birth in the US: data-driven safety improvementsR03HD096094 · NICHD · OREGON STATE UNIVERSITY · PI BOVBJERG, MARIT L · 2019 to 2020
$148k
Eunice Kennedy Shriver National Institute of Child Health and Human Development R03HD096094Fulbright Commission in IrelandNICHD NIH HHS R03 HD096094
6 · The paper itself

Abstract

objectiveInvestigate maternal and neonatal outcomes following waterbirth.

designRetrospective cohort study, with propensity score matching to address confounding.

settingCommunity births, United States. SAMPLE: Medical records-based registry data from low-risk births were used to create waterbirth and land birth groups (n = 17 530 each), propensity score-matched on >80 demographic and pregnancy risk covariables.

methodsLogistic regression models compared outcomes between the matched waterbirth and land birth groups.

main outcome measuresMaternal: immediate postpartum transfer to a hospital, any genital tract trauma, severe (3rd/4th degree) trauma, haemorrhage >1000 mL, diagnosed haemorrhage regardless of estimated blood loss, uterine infection, uterine infection requiring hospitalisation, any hospitalisation in the first 6 weeks. Neonatal: umbilical cord avulsion; immediate neonatal transfer to a hospital; respiratory distress syndrome; any hospitalisation, neonatal intensive care unit (NICU) admission, or neonatal infection in the first 6 weeks; and neonatal death.

resultsWaterbirth was associated with improved or no difference in outcomes for most measures, including neonatal death (adjusted odds ratio [aOR] 0.56, 95% CI 0.31-1.0), and maternal or neonatal hospitalisation in the first 6 weeks (aOR 0.87, 95% CI 0.81-0.92 and aOR 0.95, 95% CI 0.90-0.99, respectively). Increased morbidity in the waterbirth group was observed for two outcomes only: uterine infection (aOR 1.25, 95% CI 1.05-1.48) (but not hospitalisation for infection) and umbilical cord avulsion (aOR 1.57, 95% CI 1.37-1.82). Our results are concordant with other studies: waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. TWEETABLE ABSTRACT: New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH.

Indexed as

Natural ChildbirthPerinatal DeathCohort StudiesDelivery, ObstetricFemaleHumansInfant, NewbornPregnancyPropensity ScoreRetrospective StudiesNatural childbirthpropensity scorewater birthwaterbirth

Identifiers

PMID34773367
PMCPMC9035022
OpenAlexW3214540145

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.