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Am J Obstet Gynecol. 2011 Oct;205(4):346.e1-4. doi: 10.1016/j.ajog.2011.05.004. Epub 2011 Jun 25.

The influence of hospital type on induction of labor and mode of delivery.

Author information

1
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0526, USA. candice.snyder@uc.edu

Abstract

OBJECTIVE:

The purpose of this study was to compare labor induction and cesarean delivery rates at term in community vs university hospitals.

STUDY DESIGN:

A population-based retrospective cohort study of births was performed. Primary outcomes were term gestation at <39 weeks, labor induction, and cesarean delivery. After we adjusted for comorbidities, malpresentation, and previous cesarean delivery, logistic regression assessed the association between hospital type and primary outcomes.

RESULTS:

Births occur less often in week 37 (n = 24390 [11%] vs 4006 [13%]; adjusted odds ratio [OR], 0.9; 95% confidence interval [CI], 0.8-0.9) and are similar in week 38 in community vs university hospitals. Inductions occur more commonly in community vs university settings at 37 weeks (n = 6440 [27%] vs 757 [19%]; adjusted OR, 1.7; 95% CI, 1.5-1.8) and at 38 weeks (n = 16586 [31%] vs 1530 [21%]; adjusted OR, 1.8; 95% CI, 1.7-1.9). Cesarean rates are no different between hospital types.

CONCLUSION:

Induction is 70-80% more likely at community vs university hospitals before the optimal gestational age of ≥ 39 weeks, but cesarean delivery rates do not differ at term.

PMID:
21704962
DOI:
10.1016/j.ajog.2011.05.004
[Indexed for MEDLINE]

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