Document Detail

Trends in births at and beyond term: evidence of a change?
MedLine Citation:
PMID:  10492105     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine trends in the distribution of births at and beyond term in New South Wales and in particular, to determine whether any changes are associated with changes in the obstetric practices of induction and elective caesarean section. DESIGN: Cross-sectional analytic study. SETTING: New South Wales, Australia. POPULATION: All 540,162 women delivering a singleton cephalic-presenting infant of gestational age > or = 37 weeks from 1 January 1990 to 31 December 1996. METHODS: Data were obtained from the New South Wales midwives data collection, a population-based surveillance system covering all births in New South Wales. The data were analysed to examine changes over time and associations between gestational age, maternal factors and onset of labour. MAIN OUTCOME MEASURES: Induction of labour and elective caesarean section rates. RESULTS: From 1990 to 1996 there was a significant decrease in births reported as 40 weeks of gestation, from 35,670 (46.3%) to 30,651 (40.3%). These declines were offset by significant increases in births at 38 and 39 weeks. Births > or = 42 weeks declined from 3321 (4.6%) to 2132 (2.8%). The decline in prolonged pregnancies was associated with increasing induction rates at 41 weeks. The re-distribution of some births from 40 to 38-39 weeks was associated with increasing rates of elective caesarean sections and induction at 38 and 39 weeks, and increasing maternal age. CONCLUSIONS: Clinicians appear to be implementing the recommendations of randomised controlled trials to offer induction after 41 weeks of gestation. However the trend of performing elective caesarean sections at earlier gestational ages may be unnecessarily putting some infants at increased risk of respiratory morbidity.
C L Roberts; L Taylor; D Henderson-Smart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of obstetrics and gynaecology     Volume:  106     ISSN:  0306-5456     ISO Abbreviation:  Br J Obstet Gynaecol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7503752     Medline TA:  Br J Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  937-42     Citation Subset:  AIM; IM    
New South Wales Centre for Perinatal Health Services Research, Department of Obstetrics and Gynaecology, University of Sydney, Australia.
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MeSH Terms
Cesarean Section / statistics & numerical data*,  trends
Cross-Sectional Studies
Labor, Induced / statistics & numerical data*,  trends
Maternal Age
New South Wales / epidemiology
Pregnancy, Prolonged*
Prenatal Care / statistics & numerical data,  trends

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