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Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e2292 (Published 19 April 2012) Cite this as: BMJ 2012;344:e2292

Re: Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study

The methodology of the paper includes the low risk pregnancies for home-births etc. as per NICE Guidelines (1) which gives an exhaustive list of medical and obstetric risk factors that should be excluded before labeling the woman low-risk. However, short stature (less than 155 cms in European women) is and independent risk factor/ indication for cesarean section (2,3) is not included included in obstetric risk factors in NICE guidelines.

References:

1.National Institute for Health and Clinical Excellence (NICE). Intrapartum care of healthy women and their babies during childbirth. National Collaborating Centre for Women’s and Children’s Health. RCOG, 2007. www.nice.org.uk/nicemedia/pdf/IPCNICEguidance.pdf

2. Sheinera E, Levyb A, Katza M, Mazora M. Shortstature—an independent riskfactor for Cesarean delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology 120 (2), 1 June 2005,175–178.

3.Kappel B, Eriksen G, Hansen KB, Hvidman L, Krag-Olsen B, Nielsen J, Videbech P, Wohlert M. Short stature in Scandinavian women. An obstetrical risk factor. Acta Obstet Gynecol Scand. 1987;66(2):153-8.

Competing interests: No competing interests

22 April 2012
Neeru Gupta
neerujani@yahoo.co.in
Indian Council of Medical Research
Ansari Nagar, New Delhi-110029
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