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Am J Public Health. 2010 Nov;100(11):2241-7. doi: 10.2105/AJPH.2009.180570. Epub 2010 Sep 23.

Obstetrical intervention and the singleton preterm birth rate in the United States from 1991-2006.

Author information

1
Division of Vital Statistics, National Center for Health Statistics, Hyattsville, MD 20782, USA. mfm1@cdc.gov

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.

PMID:
20864720
PMCID:
PMC2951941
DOI:
10.2105/AJPH.2009.180570
[Indexed for MEDLINE]
Free PMC Article

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