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Obstetrical intervention and the singleton preterm birth rate in the United States from 1991-2006

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  • MacDorman, M.F.
  • Declercq, E.
  • Zhang, J.

Abstract

Objectives. We examined the relationship between obstetrical intervention and preterm birth in the United States between 1991 and 2006. Methods. We assessed changes in preterm birth, cesarean delivery, labor induction, and associated risks. Logistic regression modeled the odds of preterm obstetrical intervention after risk adjustment. Results. From 1991 to 2006, the percentage of singleton preterm births increased 13%. The cesarean delivery rate for singleton preterm births increased 47%, and the rate of induced labor doubled. In 2006, 51% of singleton preterm births were spontaneous vaginal deliveries, compared with 69% in 1991. After adjustment for demographic and medical risks, the mother of a preterm infant was 88% (95% confidence interval [CI]=1.87, 1.90) more likely to have an obstetrical intervention in 2006 than in 1991. Using new birth certificate data from 19 states, we estimated that 42% of singleton preterm infants weredelivered via induction or cesarean birth without spontaneous onset of labor. Conclusions. Obstetrical interventions were related to the increase in the US preterm birth rate between 1991 and 2006. The public health community can play a central role in reducing medically unnecessary interventions.

Suggested Citation

  • MacDorman, M.F. & Declercq, E. & Zhang, J., 2010. "Obstetrical intervention and the singleton preterm birth rate in the United States from 1991-2006," American Journal of Public Health, American Public Health Association, vol. 100(11), pages 2241-2247.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.180570_3
    DOI: 10.2105/AJPH.2009.180570
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    Cited by:

    1. VanderWeele, Tyler J. & Lantos, John D. & Lauderdale, Diane S., 2012. "Rising preterm birth rates, 1989–2004: Changing demographics or changing obstetric practice?," Social Science & Medicine, Elsevier, vol. 74(2), pages 196-201.
    2. Andrea M. Tilstra & Ryan K. Masters, 2020. "Worth the Weight? Recent Trends in Obstetric Practices, Gestational Age, and Birth Weight in the United States," Demography, Springer;Population Association of America (PAA), vol. 57(1), pages 99-121, February.
    3. Yanxia Xie & Yi Mu & Peiran Chen & Zheng Liu & Yanping Wang & Qi Li & Mingrong Li & Juan Liang & Jun Zhu, 2022. "Interrupted-time-series analysis of the immediate impact of COVID-19 mitigation measures on preterm birth in China," Nature Communications, Nature, vol. 13(1), pages 1-11, December.

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