Fewer Unnecessary Early Deliveries Seen In Multistate, Hospital-Based Study
South Carolina Seeing Similar ProgressColumbia, SC, April 08, 2013
Definition of language used in this news release:
- Early term birth: 37-38 completed weeks gestation;
- Preterm or premature birth: before 37 completed weeks gestation;
A study published today in Obstetrics & Gynecology shows that multistate, hospital-based quality improvement programs 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 in California, Florida, Illinois, New York and Texas fell significantly from 27.8 percent to 4.8 percent during the one-year project period. The March of Dimes partially funded the study.
“A Multistate Quality Improvement Program to Decrease Elective Deliveries Before 39 Weeks,” by Brian T. Oshiro, MD and others, appears in the April 8 online edition of Obstetrics & Gynecology.
South Carolina has seen similar results since the establishment of the Birth Outcomes Initiative (BOI) in 2011. The BOI is a collaborative initiative created by the South Carolina Department of Health and Human Services and its statewide partners (including, but not limited to, South Carolina Department of Health and Environmental Control, South Carolina Hospital Association and the March of Dimes) to decrease the number of low birthweight babies and to improve the health of pregnant women and their newborns.
“The last few weeks of pregnancy are important for babies, but waiting can be hard for expecting mothers and their doctors. There is a temptation to schedule deliveries for convenience, but that can lead to unnecessary complications for the baby. This is especially true if delivery is scheduled before 39 weeks of pregnancy, which is one week before the due date,” said Dr. Amy Picklesimer, Clinical Lead for the BOI and a Maternal Fetal Medicine specialist with the Greenville Health System.
“The BOI collaborative was able to bring physicians, hospitals and insurance companies together from all over South Carolina to commit to eliminating elective deliveries prior to 39 weeks,” said Dr. Picklesimer. Since August 2011, there has been a 51% reduction in the number of elective inductions performed prior to 39 weeks gestational age, and a 15% reduction in the total number of births prior to 39 weeks. There has also been a 21% drop in the total number of NICU days for babies born in South Carolina (see charts).
“South Carolina has 43 hospitals with active labor and delivery units, all of whom pledged to end early elective deliveries,” said Dr. Picklesimer. “South Carolina proves that quality initiatives can work not only in large states and big academic medical centers, but in every hospital in our state. This is tremendously exciting, and will benefit all of South Carolina’s families,” said Dr. Picklesimer
Dr. Rick Foster, Senior Vice President of Quality and Patient Safety at the South Carolina Hospital Association states: “The BOI in our state has provided a strong collaborative model for moving forward together. Reducing early elective deliveries in our state was our initial focus. We will continue to expand that focus into other areas to improve the care and outcomes of mothers and babies in South Carolina.”
Both the national study and the South Carolina initiative focused on implementation of 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 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.
The March of Dimes urges hospitals, health care providers, and patients to follow the 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. To view the latest consumer public service ad, go to YouTube at http://youtu.be/D4t0oyT3KP8.
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.
# # #