D Getahun1, K Demissie2, S W Marcella2, G G Rhoads2. 1. 1] Department of Research and Evaluation, Kaiser Permanente Southern California Medical Group, Pasadena, CA, USA [2] Department of Obstetrics and Gynecology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 2. Department of Epidemiology, Rutgers-School of Public Health, Piscataway, NJ, USA.
Abstract
OBJECTIVE: To examine trends for preterm births, stillbirths, neonatal and infant deaths in twin births by gestational age and birth weight categories, as well as trends in induction of labor and cesarean delivery during 1995-2006. STUDY DESIGN: A trend analysis was performed on data derived from the National Centers for Health Statistics' Vital Statistics Data files (1995-2006). The primary outcomes examined were preterm birth, stillbirth, neonatal and infant mortality. RESULT: During the study period, rates of labor induction among twins decreased by 8% and rates of cesarean delivery increased by 35%. Concurrently, the preterm birth rate increased by 13% from 54% in 1995-96 to 61% in 2005-06. The overall stillbirth rate, and neonatal and infant death rates decreased during the same period by 21% (95% confidence interval (CI): 18-25%), 13% (95% CI: 9-16%) and 12% (95% CI: 8-15%), respectively. There were significant reductions in neonatal death rates related to respiratory distress syndrome (RDS; 48%, 95% CI: 41-54%) and congenital anomalies (25%, 95% CI: 16-33%) during the study period. Reductions in post-neonatal infant mortality were mainly in RDS (88%) and sudden infant death syndrome (26%). Mortality rates among infants born by either induction of labor or cesarean delivery fell during the study period and remained much lower than the overall infant mortality rate. CONCLUSION: The findings of this study suggest that during 1995-2006 there was an increase in preterm birth rates and a decrease in labor inductions with a sharp decline in stillbirth, neonatal and infant mortality rates.
OBJECTIVE: To examine trends for preterm births, stillbirths, neonatal and infant deaths in twin births by gestational age and birth weight categories, as well as trends in induction of labor and cesarean delivery during 1995-2006. STUDY DESIGN: A trend analysis was performed on data derived from the National Centers for Health Statistics' Vital Statistics Data files (1995-2006). The primary outcomes examined were preterm birth, stillbirth, neonatal and infant mortality. RESULT: During the study period, rates of labor induction among twins decreased by 8% and rates of cesarean delivery increased by 35%. Concurrently, the preterm birth rate increased by 13% from 54% in 1995-96 to 61% in 2005-06. The overall stillbirth rate, and neonatal and infantdeath rates decreased during the same period by 21% (95% confidence interval (CI): 18-25%), 13% (95% CI: 9-16%) and 12% (95% CI: 8-15%), respectively. There were significant reductions in neonatal death rates related to respiratory distress syndrome (RDS; 48%, 95% CI: 41-54%) and congenital anomalies (25%, 95% CI: 16-33%) during the study period. Reductions in post-neonatal infant mortality were mainly in RDS (88%) and sudden infant death syndrome (26%). Mortality rates among infants born by either induction of labor or cesarean delivery fell during the study period and remained much lower than the overall infant mortality rate. CONCLUSION: The findings of this study suggest that during 1995-2006 there was an increase in preterm birth rates and a decrease in labor inductions with a sharp decline in stillbirth, neonatal and infant mortality rates.
Authors: M D Kogan; G R Alexander; M Kotelchuck; M F MacDorman; P Buekens; J A Martin; E Papiernik Journal: JAMA Date: 2000-07-19 Impact factor: 56.272
Authors: K S Joseph; Sylvie Marcoux; Arne Ohlsson; Michael S Kramer; Alexander C Allen; Shiliang Liu; Shi Wu Wen; Kitaw Demissie; Reg Sauve; Robert Liston Journal: Paediatr Perinat Epidemiol Date: 2002-04 Impact factor: 3.980