A planned home birth attended by a registered midwife may be safer than a hospital birth, according to a study in the Canadian Medical Association Journal.The study looked at 2889 home births attended by regulated midwives in British Columbia, Canada, and 4752 planned hospital births attended by the same cohort of midwives compared with 5331 physician-attended births in hospital.

The infant death rate per 1000 births was 0.35 for planned home births, 0.57 for midwife-attended hospital births and 0.64 for physician-attended hospital births.

In addition, women who planned a home birth had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labor, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage, and infection.

“Women planning birth at home experienced reduced risk for all obstetric interventions measured, and similar or reduced risk for adverse maternal outcomes,” writes study co-author Dr. Patricia Janssen.

CMAJ – September 15, 2009 ;Epub.

www.cmaj.ca

A new study published in the journal Sleep has found that people who suffer from insomnia have heightened nighttime blood pressure, which can lead to cardiac problems. The investigation measured the 24-hour blood pressure of 13 insomniacs compared to 13 sound sleepers. Subjects spent 40 hours in the sleep laboratory: two nights for adaptation and one for monitoring followed by the intervening day.”Over many years, chronic insomnia can have negative effects on the hearts of otherwise healthy individuals,” says lead author Paola A. Lanfranchi. “Whereas blood pressure decreases in regular sleepers and gives their heart a rest, insomnia provokes higher nighttime blood pressure that can cause long-term cardiovascular risks and damage the heart.”

“Blood pressure cycles are mainly linked to the sleep-wake cycle,” adds co-author Jacques Montplaisir. “Since blood pressure is heightened among insomniacs, those with overt cardiac disease are particularly at risk for progression of the disease.”

Sleep –  June 2009;32:760-66.

www.journalsleep.org

A new analysis compares chiropractic patients with medical patients. Specifically, it looks at modifiable risk factors of chronic disease in the two groups.Researchers pooled data from the National Health Interview Survey 2005 adult sample, which comprised 31,248 people. They determined that, during the past 12 months, 9.3% had seen a chiropractor. Of these, 21.4% did not see a medical doctor.

“Comparing chiropractor-only with medical doctor-only patients, we found no significant difference in smoking/alcohol consumption status, but chiropractor-only patients were more likely to be physically active … and less likely to be obese.”

The study’s authors conclude: “Based on these analyses, Americans seem to be using chiropractic care for acute neck and low back pain more so than for other health conditions. However, there is no marked difference in their overall health promotion habits and changes in overall general health based on health care provider types.”

JMPT – July 2009;32:414-22.

www.jmptonline.org