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Updated: May 12, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Early term birth: the impact of practice patterns on rates and outcomes
Barbara S McAlister1, Mari Tietze, Sally Northam
1Texas Woman's University, College of Nursing, 5500 Southwestern Medical Avenue, Dallas, TX 75235, USA. bmcalister@twu.edu
Abstract:
The American College of Obstetricians and Gynecologists guidelines discourage elective deliveries before 39 weeks gestation, but clinicians continue to schedule elective inductions and cesareans resulting in births at 37 0/7 to 38 6/7 weeks gestation. These "early term" (ET) infants incur more morbidity and mortality than their 39-to-41-week counterparts. Using the Quality Health Outcomes Model, four hypotheses were tested: Among hospitals in one southwestern U.S. county, there are different rates of ET births, ET births preceded by elective labor induction, ET births preceded by elective cesarean section, and Neonatal Intensive Care Unit (NICU) admissions of ET infants. Analyses of 75,625 birth certificates involved 26,199 ET and 49,426 full term births in 16 hospitals. Chi-square analyses revealed significant differences in rates among hospitals for ET births, ET births preceded by elective labor induction, and ET births preceded by elective cesarean section, but no significant differences in NICU admissions. Wide variance across hospitals demonstrated practice patterns amenable to improvements.
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