STUDY FINDS UNNECESSARY EARLY DELIVERIES OF BABIES REDUCED CONSIDERABLY - Local Hospitals Join March of Dimes Multi-state Quality Improvement Program
Maitland, Florida, April 08, 2013
A study published today in Obstetrics & Gynecology shows that multistate, hospital-based quality improvement programs, including those piloted in Florida, can be remarkably effective at reducing early elective deliveries of babies.
The rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason) in a group of 25 participating hospitals, including Lee Memorial Health System, Ft. Myers; Santa Rosa Medical Center, Milton; South Miami Hospital, Miami; Broward Health Medical Center, Fort Lauderdale; and St. Joseph Women’s Hospital, Tampa, fell significantly from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline.
The March of Dimes Florida Chapter, which partly funded the initiative, says this is good news because babies delivered before full-term are at increased risk of serious health problems and death in their first year of life.
“This quality improvement program demonstrates that we can create a change in medical culture to prevent unneeded early deliveries and give many more babies a healthy start in life,” says Bryan T. Oshiro, MD, of Loma Linda University School of Medicine and lead author of the study.
“Reducing unnecessary early deliveries to less than 5 percent means that more babies stayed in the womb longer, which is so important for their growth and development,” says William M. Sappenfield, Ph.D., of University of South Florida and one of the authors of the study. “Overall, this project saw a decrease in the proportion of babies born at 37 and 38 weeks and a corresponding increase in the 39-41 week range during the one-year period studied.”
In Florida, the March of Dimes supported the quality improvement efforts with grant funds, including grants to the University of South Florida to support the Florida Perinatal Quality Collaborative, and with funding to the Florida Association of Healthy Start Coalitions to improve awareness among women about the message, “if your pregnancy is healthy, it’s best to wait for labor to begin on its own.”
The Florida hospitals implemented a toolkit called “Elimination of Non-medically Indicated (Elective) Deliveries before 39 Weeks Gestational Age” to guide changes in early term delivery practices. The toolkit was developed in partnership with the March of Dimes, the California Maternal Quality Care Collaborative and the California Maternal Child and Adolescent Division within the California Department of Public Health. It can be downloaded free from the Prematurity Prevention Resource Center at prematurityprevention.org.
These hospitals in Florida are among the first in the nation to participate in a collaborative of perinatal quality improvement advocates with state health departments, academic health centers, and March of Dimes chapters from the five most populous states in the country. Florida accounts for more than 5 percent of all births in the United States. Together with California, Illinois, New York and Texas, the state accounts for an estimated 38 percent of all births in the U.S.
The March of Dimes urges hospitals, health care providers, and patients to follow American College of Obstetricians and Gynecologists guidelines that if a pregnancy is healthy, to wait for labor to begin on its own. The final weeks of pregnancy are crucial to a baby’s health because many vital organs, including the brain and lungs, are still developing.
The March of Dimes has worked with local and national partners, including the U.S. Department of Health and Human Services “Strong Start” initiative, on a campaign to raise awareness about the importance of full-term pregnancy. To see the latest public service ad, go to YouTube at http://youtu.be/D4t0oyT3KP8.
“A Multistate Quality Improvement Program to Decrease Elective Deliveries Before 39 Weeks,” by Dr. Oshiro and others, appears in the April 8 online edition of Obstetrics & Gynecology Vol. 121, No. 5, May 2013.
In 2013, the March of Dimes celebrates its 75th anniversary and its ongoing work to help babies get a healthy start in life. About 4 million babies are born each year in the U.S., and the March of Dimes helps each one through research, education, vaccines, and breakthroughs.
The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org. Find us on Facebook and follow us on Twitter.