The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.

We examined the relationship between obstetrical intervention and preterm birth in the United States between 2014 and 2019. This observational study analyzed 2014-2019 US birth data to assess changes in preterm birth, cesarean delivery, induction of labor, and associated risks. Logistic regression m...

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Main Authors: Marian F MacDorman, Marie Thoma, Eugene Declercq, Elizabeth A Howell
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0265146
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author Marian F MacDorman
Marie Thoma
Eugene Declercq
Elizabeth A Howell
author_facet Marian F MacDorman
Marie Thoma
Eugene Declercq
Elizabeth A Howell
author_sort Marian F MacDorman
collection DOAJ
description We examined the relationship between obstetrical intervention and preterm birth in the United States between 2014 and 2019. This observational study analyzed 2014-2019 US birth data to assess changes in preterm birth, cesarean delivery, induction of labor, and associated risks. Logistic regression modeled the odds of preterm obstetrical intervention (no labor cesarean or induction) after risk adjustment. The percentage of singleton preterm births in the United States increased by 9.4% from 2014-2019. The percent of singleton, preterm births delivered by cesarean increased by 6.0%, while the percent with induction of labor increased by 39.1%. The percentage of singleton preterm births where obstetrical intervention (no labor cesarean or induction) potentially impacted the gestational age at delivery increased from 47.6% in 2014 to 54.9% in 2019. Preterm interventions were 13% more likely overall in 2019 compared to 2014 and 17% more likely among late preterm births, after controlling for demographic and medical risk factors. Compared to non-Hispanic White women, Non-Hispanic Black women had a higher risk of preterm obstetric interventions. Preterm infants have higher morbidity and mortality rates than term infants, thus any increase in the preterm birth rate is concerning. A renewed effort to understand the trends in preterm interventions is needed to ensure that obstetrical interventions are evidence-based and are limited to those cases where they optimize outcomes for both mothers and babies.
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spelling doaj.art-e1804b90ff144bc1861759645bbf81752022-12-22T00:21:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026514610.1371/journal.pone.0265146The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.Marian F MacDormanMarie ThomaEugene DeclercqElizabeth A HowellWe examined the relationship between obstetrical intervention and preterm birth in the United States between 2014 and 2019. This observational study analyzed 2014-2019 US birth data to assess changes in preterm birth, cesarean delivery, induction of labor, and associated risks. Logistic regression modeled the odds of preterm obstetrical intervention (no labor cesarean or induction) after risk adjustment. The percentage of singleton preterm births in the United States increased by 9.4% from 2014-2019. The percent of singleton, preterm births delivered by cesarean increased by 6.0%, while the percent with induction of labor increased by 39.1%. The percentage of singleton preterm births where obstetrical intervention (no labor cesarean or induction) potentially impacted the gestational age at delivery increased from 47.6% in 2014 to 54.9% in 2019. Preterm interventions were 13% more likely overall in 2019 compared to 2014 and 17% more likely among late preterm births, after controlling for demographic and medical risk factors. Compared to non-Hispanic White women, Non-Hispanic Black women had a higher risk of preterm obstetric interventions. Preterm infants have higher morbidity and mortality rates than term infants, thus any increase in the preterm birth rate is concerning. A renewed effort to understand the trends in preterm interventions is needed to ensure that obstetrical interventions are evidence-based and are limited to those cases where they optimize outcomes for both mothers and babies.https://doi.org/10.1371/journal.pone.0265146
spellingShingle Marian F MacDorman
Marie Thoma
Eugene Declercq
Elizabeth A Howell
The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
PLoS ONE
title The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
title_full The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
title_fullStr The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
title_full_unstemmed The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
title_short The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019.
title_sort relationship between obstetrical interventions and the increase in u s preterm births 2014 2019
url https://doi.org/10.1371/journal.pone.0265146
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