OBJECTIVE: No studies exist that have examined the effectiveness of different approaches to a reduction in elective early term deliveries or the effect of such policies on newborn intensive care admissions and stillbirth rates. STUDY DESIGN: We conducted a retrospective cohort study of prospectively collected data and examined outcomes in 27 hospitals before and after implementation of 1 of 3 strategies for the reduction of elective early term deliveries. RESULTS: Elective early term delivery was reduced from 9.6-4.3% of deliveries, and the rate of term neonatal intensive care admissions fell by 16%. We observed no increase in still births. The greatest improvement was seen when elective deliveries at <39 weeks were not allowed by hospital personnel. CONCLUSION: Physician education and the adoption of policies backed only by peer review are less effective than "hard stop" hospital policies to prevent this practice. A 5% rate of elective early term delivery would be reasonable as a national quality benchmark.
OBJECTIVE: No studies exist that have examined the effectiveness of different approaches to a reduction in elective early term deliveries or the effect of such policies on newborn intensive care admissions and stillbirth rates. STUDY DESIGN: We conducted a retrospective cohort study of prospectively collected data and examined outcomes in 27 hospitals before and after implementation of 1 of 3 strategies for the reduction of elective early term deliveries. RESULTS: Elective early term delivery was reduced from 9.6-4.3% of deliveries, and the rate of term neonatal intensive care admissions fell by 16%. We observed no increase in still births. The greatest improvement was seen when elective deliveries at <39 weeks were not allowed by hospital personnel. CONCLUSION: Physician education and the adoption of policies backed only by peer review are less effective than "hard stop" hospital policies to prevent this practice. A 5% rate of elective early term delivery would be reasonable as a national quality benchmark.
Authors: Sascha Dublin; Karin E Johnson; Rod L Walker; Lyndsay A Avalos; Susan E Andrade; Sarah J Beaton; Robert L Davis; Lisa J Herrinton; Pamala A Pawloski; Marsha A Raebel; David H Smith; Sengwee Toh; Aaron B Caughey Journal: J Womens Health (Larchmt) Date: 2014-10-20 Impact factor: 2.681
Authors: Lindsay S Womack; William M Sappenfield; Cheryl L Clark; Washington C Hill; Robert W Yelverton; John S Curran; Linda A Detman; Vani R Bettegowda Journal: Matern Child Health J Date: 2014-10