Trends in Neonatal Outcomes After Iatrogenic Preterm Delivery
Author Information
Author(s): Sarka Lisonkova, Jennifer A Hutcheon, KS Joseph
Primary Institution: University of British Columbia
Hypothesis
There have been larger declines in neonatal mortality and serious neonatal morbidity among preterm infants born following obstetric intervention compared to those born following spontaneous preterm labor.
Conclusion
Increases in iatrogenic preterm birth have been accompanied by declines in perinatal mortality, with larger declines observed among iatrogenic preterm births compared to spontaneous preterm births.
Supporting Evidence
- Preterm birth rates increased from 7.3 to 8.8 per 100 live births from 1995 to 2005.
- Stillbirth rates declined from 3.4 to 3.0 per 1,000 total births during the same period.
- Neonatal mortality rates declined from 2.4 to 2.1 per 1,000 live births.
Takeaway
Doctors are helping more babies be born early for medical reasons, and this has led to fewer babies dying or getting very sick after birth.
Methodology
Data on singleton and twin births in the US from 1995-2005 was analyzed to examine trends in stillbirths, neonatal deaths, and serious neonatal morbidity.
Potential Biases
Some cases of spontaneous preterm labor may have been misclassified as iatrogenic due to lack of detailed data on labor onset.
Limitations
Potential misclassification of preterm birth subtypes and exclusion of data from states with new birth certificate forms.
Participant Demographics
The study included singleton and twin births in the United States, with changes in maternal characteristics such as age and education noted over the study period.
Statistical Information
P-Value
p<0.001
Confidence Interval
0.73-0.77
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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