Abstract:
OBJECTIVES:We examined the relationship between obstetrical intervention and preterm birth in the United States between 1991 and 2006. METHODS:We assessed changes in preterm birth, cesarean delivery, labor induction, and associated risks. Logistic regression modeled the odds of preterm obstetrical intervention after risk adjustment. RESULTS:From 1991 to 2006, the percentage of singleton preterm births increased 13%. The cesarean delivery rate for singleton preterm births increased 47%, and the rate of induced labor doubled. In 2006, 51% of singleton preterm births were spontaneous vaginal deliveries, compared with 69% in 1991. After adjustment for demographic and medical risks, the mother of a preterm infant was 88% (95% confidence interval [CI] = 1.87, 1.90) more likely to have an obstetrical intervention in 2006 than in 1991. Using new birth certificate data from 19 states, we estimated that 42% of singleton preterm infants were delivered via induction or cesarean birth without spontaneous onset of labor. CONCLUSIONS:Obstetrical interventions were related to the increase in the US preterm birth rate between 1991 and 2006. The public health community can play a central role in reducing medically unnecessary interventions.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
MacDorman MF,Declercq E,Zhang Jdoi
10.2105/AJPH.2009.180570subject
Has Abstractpub_date
2010-11-01 00:00:00pages
2241-7issue
11eissn
0090-0036issn
1541-0048pii
AJPH.2009.180570journal_volume
100pub_type
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2011-12-01 00:00:00
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journal_title:American journal of public health
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pub_type: 临床试验,杂志文章,随机对照试验
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