The effect of obstetric practice change to reduce early term delivery on perinatal outcome.

TitleThe effect of obstetric practice change to reduce early term delivery on perinatal outcome.
Publication TypeJournal Article
Year of Publication2014
AuthorsLittle SE, Robinson JN, Puopolo KM, Mukhopadhyay S, Wilkins-Haug LE, Acker DA, Zera CA
JournalJ Perinatol
Volume34
Issue3
Pagination176-80
Date Published2014 Mar
ISSN1476-5543
KeywordsCesarean Section, Delivery, Obstetric, Female, Gestational Age, Humans, Infant, Newborn, Infant, Newborn, Diseases, Pregnancy, Retrospective Studies, Stillbirth, Term Birth
Abstract

OBJECTIVE: To investigate whether the national emphasis on attaining 39 weeks gestation has altered obstetric practice, and if so whether this has affected perinatal morbidity.

STUDY DESIGN: We examined trends in gestational age, neonatal morbidity, maternal complications and stillbirth for a retrospective cohort of singleton, live births between 37+0 and 39+6 weeks of gestation over a 5-year period at a single tertiary care center.

RESULT: There were 21 343 eligible deliveries. The proportion of deliveries in the early term (<39 weeks) decreased from 47.8 to 40.2% (P<0.01). The reduction was most pronounced for elective inductions (27.5 to 8.0%; P<0.01) and scheduled cesareans (56.9 to 24.9%; P<0.01), although a similar trend was seen for nonelective inductions (51.2 to 47.9%; P=0.03). In multivariable analysis, there was a 10% decreased odds of early term delivery per year (P<0.01). There were no changes in the rates of neonatal intensive care unit (NICU) evaluation (29.8 to 28.1%; P=0.11), pre-eclampsia (7.6 to 8.5%; P=0.06) or stillbirth (11.5 to 14.4 per 10 000; P=0.55).

CONCLUSION: A 10% annual decline in the odds of early term delivery was not accompanied by significant changes in perinatal morbidity.

DOI10.1038/jp.2013.166
Alternate JournalJ Perinatol
PubMed ID24406741