The influence of hospital type on induction of labor and mode of delivery

作者：Snyder Candice C^*; Wolfe Katherine B; Loftin Ryan W; Tabbah Sammy; Lewis David F; Defranco Emily A

来源：American Journal of Obstetrics and Gynecology, 2011, 205(4): 346.e1.

DOI：10.1016/j.ajog.2011.05.004

• cesarean delivery
• community hospital
• hospital type
• induction of labor
• university hospital

OBJECTIVE: The purpose of this study was to compare labor induction and cesarean delivery rates at term in community vs university hospitals.
STUDY DESIGN: A population-based retrospective cohort study of births was performed. Primary outcomes were term gestation at <39 weeks, labor induction, and cesarean delivery. After we adjusted for comorbidities, malpresentation, and previous cesarean delivery, logistic regression assessed the association between hospital type and primary outcomes.
RESULTS: Births occur less often in week 37 (n = 24390 [11%] vs 4006 [13%]; adjusted odds ratio [OR], 0.9; 95% confidence interval [CI], 0.8-0.9) and are similar in week 38 in community vs university hospitals. Inductions occur more commonly in community vs university settings at 37 weeks (n = 6440 [27%] vs 757 [19%]; adjusted OR, 1.7; 95% CI, 1.5-1.8) and at 38 weeks (n = 16586 [31%] vs 1530 [21%]; adjusted OR, 1.8; 95% CI, 1.7-1.9). Cesarean rates are no different between hospital types.
CONCLUSION: Induction is 70-80% more likely at community vs university hospitals before the optimal gestational age of >= 39 weeks, but cesarean delivery rates do not differ at term.

• 出版日期2011-10