Study Published Today Finds Unnecessary Early Deliveries of Babies Reduced Considerably
New York Hospitals Join March of Dimes Multistate Quality Improvement Program StudyNew York, NY, April 08, 2013
Definition of language used in this news release:
- Early term birth: 37-38 completed weeks gestation;
- Full-term birth: refers to 39 to 41 weeks completed gestation;
- Preterm or premature birth: before 37 completed weeks gestation;
New York City, April 8, 2013 – A study published today in Obstetrics & Gynecology shows that multi-state, hospital-based quality improvement programs, including those piloted in New York, 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 significantly decreased from 27.8 percent to 4.8 percent during the one-year project period, an 83 percent decline. New York State hospitals participating in the study included Stony Brook University Hospital and Claxton-Hepburn Medical Center.
The March of Dimes, 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 Gerald Quirk, MD, PhD, Professor in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook University School of Medicine. “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.”
To help move the needle further here in New York, the March of Dimes has established a Centering Pregnancy Exchange Network designed to share best practices among seven projects. They will track C-sections and breastfeeding rates to help make an overall impact on delivery of care at the host sites. CenteringPregnancy® (CP) programs increase the amount of time a pregnant mom spends with her healthcare provider, as well as create peer support, which will ultimately help more women have full-term pregnancies and healthy babies.
The March of Dimes New York State Chapter has also launched a pilot project-Consumer Education Initiative (CEI) to make women aware of the benefits of letting labor begin on its own. Through this program, women will now be receiving information and education in a more comprehensive and effective format.
The New York State 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 New York State 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. In New York State, more than 244,375 babies are born each year, accounting for nearly 6.1 percent of all births in the United States. Together with California, Florida, Illinois 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.
“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.
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.org or nacersano.org. Find us on Facebook and follow us on Twitter.