Neonatal Outcomes of Water Delivery versus Land Delivery: A Retrospective Propensity Score Weighted Study. in American journal of perinatology / Am J Perinatol. 2024 May;41(S 01):e1775-e1782. doi: 10.1055/s-0043-1768961. Epub 2023 May 19.

2024
ASL Biella

Tipo pubblicazione

Journal Article

Autori/Collaboratori (13)Vedi tutti...

Franchi MP
Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Carlo Zorzato P
Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Biancotto G
Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.

et alii...

Abstract

OBJECTIVE: ?Recent evidence has shown that water delivery is safe for the mother, but high-quality evidence is not available for the newborn. Therefore, obstetric guidelines do not support it. This retrospective study aimed to contribute to the available evidence on maternal and neonatal outcomes associated with water delivery. STUDY DESIGN: ?Retrospective cohort study from prospectively collected birth registry data from 2015 to 2019. A total of 144 consecutive water deliveries and 265 land deliveries eligible for waterbirth were identified. The inverse probability of treatment weighting (IPTW) method was applied to address for confounders. RESULTS: ?We identified 144 women who delivered in water (water group) and 265 women who delivered on land (land group). One (0.7%) neonatal death was observed in the water delivery group. After IPTW adjustment, water delivery was significantly associated with a higher risk of maternal fever in puerperium (odds ratio [OR]: 4.98; 95% confidence interval [CI]: 1.86-17.02; p?=?0.004), of neonatal cord avulsion (OR: 20.73; 95% CI: 2.63-2,674; p?=?0.001), and of positive neonatal C-reactive protein (CRP?>?5?mg/L; OR: 2.59; 95% CI: 1.05-7.24; p?=?0.039); delivering in water was associated with lower maternal blood loss (mean difference: 110.40?mL; 95% CI: 191.01-29.78; p?=?0.007), a lower risk of major (?1,000?mL) postpartum hemorrhage (OR: 0.96; 95% CI: 0.92-0.99; p?=?0.016), lower risk of manual placenta delivery (OR: 0.18; 95% CI: 0.03-0.67; p?=?0.008) and curettage (OR: 0.24; 95% CI: 0.08-0.60; p?=?0.002), lower use of episiotomy (OR: 0.02; 95% CI: 0-0.12; p?