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Extreme obesity and chronic lung disease are significant high-risk factors that can adversely affect the course of pregnancy and labor. Chronic lung disease can lead to complications such as respiratory distress, decreased oxygenation, and the need for emergency interventions. Obesity, particularly when classified as extreme, is associated with a higher risk of gestational diabetes, hypertension, and complications during labor, such as increased chances of cesarean delivery.

These conditions can pose serious threats to both the mother and the baby during a home birth where immediate medical support might not be readily available. Therefore, these factors would typically lead healthcare providers to recommend a hospital birth setting, where comprehensive medical care and emergency interventions can be promptly delivered if needed.

In contrast, while other options contain various risk factors, they are generally not as universally disqualifying for home birth as the combination of chronic lung disease and extreme obesity is.