<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_joepi-2018-001_s_001"><h3>Background.</h3><p>Planned homebirth is an option available to a small minority of expecting mothers. Compared with hospital births, long-term risks of homebirths are poorly known.</p></sec><sec id="j_joepi-2018-001_s_002"><h3>Aim</h3><p>To study very long-term outcome for death, seizure remission, and other neurological long-term comorbidities</p></sec><sec id="j_joepi-2018-001_s_003"><h3>Material and Methods.</h3><p>A cohort of virtually all children (n = 230) in a geographically defined area with onset of epilepsy in or active epilepsy diagnosed prior to 1961–1964, and prospectively followed-up for 50 years.</p></sec><sec id="j_joepi-2018-001_s_004"><h3>Results.</h3><p>The proportion of homebirths was 16% in blue collar families and 2% in white collar families (p = 0.007). No significant differences between homebirths and hospital births were found in the frequencies of either abnormal pregnancy (27% vs 27%, p > 0.99) or abnormal birth (32% vs 35%, p = 0.82). Premature mortality following homebirths was non-significantly higher than that following hospital births (41% vs 27%, p = 0.13). Homebirth did not significantly affect 5-year (38% vs 40%) or 10-year (38% vs 37%) remission. Neither was homebirth alone associated with neurological morbidity (2.1, 0.82–6.1, p = 0.137).</p></sec><sec id="j_joepi-2018-001_s_005"><h3>Conclusion.</h3><p>Homebirth is an observable but non-significant risk factor of offspring mortality and neurological morbidity of an offspring with epilepsy. Blue collar families preferred homebirth to hospital birth for reasons which are not fully understood. Further research is needed in a prospective setting by applying modern standards of early identification of risk pregnancies and deliveries, carefully monitoring the health of expecting mothers, and anticipating referral to specialist services according to medical needs.</p></sec></abstract>

Background.Planned homebirth is an option available to a small minority of expecting mothers. Compared with hospital births, long-term risks of homebirths are poorly known.AimTo study very long-term outcome for death, seizure remission, and other neurological long-term comorbiditiesMaterial and Methods.A cohort of virtually all children (n = 230) in a geographically defined area with onset of epilepsy in or active epilepsy diagnosed prior to 1961–1964, and prospectively followed-up for 50 years.Results.The proportion of homebirths was 16% in blue collar families and 2% in white collar families (p = 0.007). No significant differences between homebirths and hospital births were found in the frequencies of either abnormal pregnancy (27% vs 27%, p > 0.99) or abnormal birth (32% vs 35%, p = 0.82). Premature mortality following homebirths was non-significantly higher than that following hospital births (41% vs 27%, p = 0.13). Homebirth did not significantly affect 5-year (38% vs 40%) or 10-year (38% vs 37%) remission. Neither was homebirth alone associated with neurological morbidity (2.1, 0.82–6.1, p = 0.137).Conclusion.Homebirth is an observable but non-significant risk factor of offspring mortality and neurological morbidity of an offspring with epilepsy. Blue collar families preferred homebirth to hospital birth for reasons which are not fully understood. Further research is needed in a prospective setting by applying modern standards of early identification of risk pregnancies and deliveries, carefully monitoring the health of expecting mothers, and anticipating referral to specialist services according to medical needs.

Long-term offspring epilepsy outcomes following planned assisted homebirth versus hospital birth

Journal of Epileptology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background.Planned homebirth is an option available to a small minority of expecting mothers. Compared with hospital births, long-term risks of homebirths are...

	Univariatea	Multivariableb
HR	(95% CI)	p-value	HR	(95% CI)
5YTR, 2 years off-AEDs
Home birth	1.1	(0.6–2.0)	0.854	1.4	(0.8–2.5)	0.269
Abnormal birth	0.5	(0.3–0.8)	0.002	0.5	(0.3–0.7)	0.002
Abnormal pregnancy	0.8	(0.5–1.3)	0.432	–
Cognitive disability in 1^st degree relatives	1.0	(0.6–1.6)	0.993	–
Clustering of seizures	0.8	(0.5–1.5)	0.510	–

10YTR, 5years off-AEDs
Home birth	1.2	(0.6–2.2)	0.588	1.6	(0.9–2.9)	0.123
Abnormal birth	0.4	(0.3–0.7)	0.002	0.4	(0.3–0.7)	0.001
Abnormal pregnancy	0.8	(0.5–1.4)	0.497	–
Cognitive disability in 1^st degree relatives	1.0	(0.6–1.6)	0.939	–
Clustering of seizures	1.0	(0.5–1.7)	0.880	–

	Univariatea			Multivariableb
	HR	(95% CI)	p-value	HR	(95% CI)
Death
Home birth	1.5	(0.8–2.7)	0.235	1.3	(0.7–2.5)	0.391
Clustering of seizures	2.0	(1.2–3.5)	0.011	2.0	(1.1–3.3)	0.014
Abnormal birth	1.3	(0.8–2.1)	0.382	–
Abnormal pregnancy	1.3	(0.7–2.1)	0.466	–
Cognitive disability in 1^st degree relatives	0.8	(0.4–1.6)	0.576	–

Long-term offspring epilepsy outcomes following planned assisted homebirth versus hospital birth

Article Category: research-article

Published Online: Feb 13, 2018

Page range: 7 - 14

Received: Jan 09, 2018

Accepted: Jan 16, 2018

DOI: https://doi.org/10.21307/joepi-2018-001

Keywords
home birth, epilepsy, long-term study, mortality, seizure outcome

© 2018 Matti Sillanpaa., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1.

Figure 2.

Figure 3.

Univariate and multivariable analyses for predictors of seizure outcome in homebirths vs hospital births

Univariate and multivariable analyses for predictors of long-term survival in homebirths vs hospital births

Long-term offspring epilepsy outcomes following planned assisted homebirth versus hospital birth

Article Category: research-article

Published Online: Feb 13, 2018

Page range: 7 - 14

Received: Jan 09, 2018

Accepted: Jan 16, 2018

DOI: https://doi.org/10.21307/joepi-2018-001

Keywordshome birth, epilepsy, long-term study, mortality, seizure outcome

© 2018 Matti Sillanpaa., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1.

Figure 2.

Figure 3.

Univariate and multivariable analyses for predictors of seizure outcome in homebirths vs hospital births

Univariate and multivariable analyses for predictors of long-term survival in homebirths vs hospital births

Keywords
home birth, epilepsy, long-term study, mortality, seizure outcome