Rates of labor induction and primary cesarean delivery do not correlate with rates of adverse neonatal outcome in level I hospitals

Abstract

Objective. To determine whether variation in rates of labor induction (IOL) and primary cesarean delivery (PCD) among level I hospitals is associated with differences in neonatal outcomes.

Methods. A birth certificate database was used to calculate crude and adjusted rates of IOL and PCD among 10 regional hospitals. Adjustment via logistic regression controlled for differences in medical and demographic factors. Linear regression assessed the relationship of crude and adjusted IOL and PCD rates to rates of three neonatal outcomes.

Results. IOL and PCD rates varied widely among hospitals (1.79- and 1.72-fold, respectively); variation increased following adjustment (1.93- and 1.86-fold, respectively). Rates of adverse neonatal outcomes varied by year and hospital, but not by IOL or PCD rates (p ≥ 0.05).

Conclusions. Crude and adjusted rates of labor induction and PCD vary among level I hospitals, but with no consistent effect on neonatal outcome.

Keywords:

• Labor
• interventions
• NICU admission
• ventilation
• low Apgar

Acknowledgements

Partial funding of this study was through grant contract C-023908, New York State Department of Health.