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The association between obstetrical interventions and late preterm birth.
Kate L Bassil1, Abdool S Yasseen2, Mark Walker2
1Maternal-Infant Care Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
American Journal of Obstetrics and Gynecology
|March 4, 2014
Summary
Late preterm (LP) births are less likely to involve obstetric interventions like induction or cesarean section compared to full-term births. This suggests healthcare providers may avoid these interventions for LP infants.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Perinatal Medicine
- Public Health
Background:
- Late preterm (LP) birth, defined as 34 to 36 completed weeks of gestation, is a growing concern.
- Obstetric interventions, including prelabor cesarean section and induced delivery, are suspected drivers of LP birth.
- Understanding the association between interventions and LP birth is crucial for optimizing perinatal care.
Purpose of the Study:
- To evaluate the independent association between obstetric interventions and LP birth.
- To identify independent maternal and fetal risk factors associated with LP birth.
Main Methods:
- Population-based cross-sectional study using the BORN Information System (2005-2012) in Ontario, Canada.
- Inclusion of all infants born between 34 and 40 completed weeks of gestation.
- Generalized estimating equation regression used to assess the association between obstetric interventions and LP birth.
Main Results:
- Of 917,013 births, 5.4% were LP. Obstetric interventions (induction, prelabor cesarean section) were associated with a lower likelihood of LP birth (RR 0.65-0.71).
- Identified risk factors for LP birth included previous cesarean section (RR 1.28), smoking during pregnancy (RR 1.28), and material/social deprivation indices (RR 1.1-1.09).
Conclusions:
- LP births demonstrated a 35% lower likelihood of obstetric interventions compared to term births, after adjusting for risk factors.
- Findings suggest obstetric care providers may be preferentially avoiding induction and prelabor cesarean section for gestations between 34 and 37 weeks.
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