Theory of obstetrics: An epidemiologic framework for justifying medically indicated early delivery
2007

The Fetuses at Risk Approach in Obstetrics

publication Evidence: moderate

Author Information

Author(s): Joseph K S

Primary Institution: Dalhousie University

Hypothesis

Can the fetuses at risk approach provide a coherent framework for justifying medically indicated early delivery in obstetrics?

Conclusion

The fetuses at risk approach reconciles the paradox of modern obstetrics by providing a theoretical justification for medically indicated early delivery.

Supporting Evidence

  • Between 1995-96 and 1999-2000, rates of labor induction/cesarean delivery increased by 45.1 per 1,000.
  • Perinatal mortality decreased by 0.31 per 1,000 total births during the same period.
  • The marginal number needed to treat was calculated to be 145 to prevent one perinatal death.

Takeaway

This study explains that delivering babies early when there are risks can actually help save lives, even though it seems like it would cause more problems.

Methodology

The study analyzes trends in labor induction and cesarean delivery rates alongside perinatal mortality data from the United States.

Potential Biases

Potential biases may arise from changes in maternal characteristics over time that could affect outcomes.

Limitations

The study relies on historical data and assumptions about the relationship between obstetric interventions and outcomes.

Participant Demographics

The study focuses on singleton pregnancies and includes data from various gestational ages.

Statistical Information

P-Value

0.0001

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1186/1471-2393-7-4

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