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

Candice C. Snyder, Katherine B. Wolfe, Ryan W. Loftin, Sammy Tabbah, David F. Lewis, Emily A. Defranco

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)346.e1-346.e4
JournalAmerican Journal of Obstetrics and Gynecology
Volume205
Issue number4
DOIs
StatePublished - Oct 2011

Keywords

  • Cesarean delivery
  • Community hospital
  • Hospital type
  • Induction of labor
  • University hospital

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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