Gurol-Urganci, Ipek; Jardine, Jennifer; Carroll, Fran; Frémeaux, Alissa; Muller, Patrick; Relph, Sophie; Waite, Lara; Webster, Kirstin; Oddie, Sam; Hawdon, Jane; +4 more... Harris, Tina; Khalil, Asma; van der Meulen, Jan; National Maternity and Perinatal Audit Project Team; (2022) Use of induction of labour and emergency caesarean section and perinatal outcomes in English maternity services: a national hospital-level study. BJOG : An international journal of obstetrics and gynaecology, 129 (11). pp. 1899-1906. ISSN 1470-0328 DOI: https://doi.org/10.1111/1471-0528.17193
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Abstract
OBJECTIVES: To assess the association between hospital-level rates of induction of labour and emergency caesarean section, as measures of "practice style", and rates of adverse perinatal outcomes. DESIGN: National study using electronic maternity records. SETTING: English National Health Service. PARTICIPANTS: Hospitals providing maternity care to women between April 2015 and March 2017. MAIN OUTCOME MEASURES: Stillbirth, admission to a neonatal unit, and babies receiving mechanical ventilation. RESULTS: Among singleton term births, the risk of stillbirth was 0.15%; of admission to a neonatal unit 5.4%; and of mechanical ventilation 0.54%. There was considerable between-hospital variation in the induction of labour rate (minimum 17.5%, maximum 40.7%) and the emergency caesarean section rate (minimum 5.6%, maximum 17.1%). Women who gave birth in hospitals with a higher induction of labour rate had better perinatal outcomes. For each 5%-point increase in induction, there was a decrease in the risk of term stillbirth by 9% (OR 0.91; 95% CI 0.85 to 0.97) and mechanical ventilation by 14% (OR 0.86; 95% CI 0.79 to 0.94). There was no significant association between hospital-level induction of labour rates and neonatal unit admission at term (p>0.05). There was no significant association between hospital-level emergency caesarean section rates and adverse perinatal outcomes (p always >0.05). CONCLUSIONS: There is considerable between-hospital variation in the use of induction of labour and emergency caesarean section. Hospitals with a higher induction rate had a lower risk of adverse birth outcomes. A similar association was not found for caesarean section.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Dept of Health Services Research and Policy |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 35445784 |
Elements ID | 176702 |
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Filename: Gurol-Urganci-etal-2022_Use_of_induction_of_labour.pdf
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