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More interventions at delivery not linked to healthier newborns
Date:4/13/2011

In low-risk pregnant women, high induction and first-cesarean delivery rates do not lead to improved outcomes for newborns, according to new research published in the April issue of The Journal of Maternal-Fetal and Neonatal Medicine.

The finding that rates of intervention at delivery whether high, low, or in the middle had no bearing on the health of new babies brings into question the skyrocketing number of both inductions and cesarean deliveries in the United States.

"Like virtually all medical therapies and procedures, these interventions entail some risk for the mother, and there is no evidence in this study that they benefit the baby," said Christopher Glantz, M.D., M.P.H., study author and professor of Maternal Fetal Medicine at the University of Rochester Medical Center. "In my mind, if you are getting the same outcome with high and low rates of intervention, I say 'Do no harm' and go with fewer interventions."

Similar to other fields of medicine, great variation exists in obstetric practices, particularly in rates of induction of labor and cesarean delivery. A limited number of studies have examined if and how these rates are associated with improvement in the health of newborns and reported mixed results.

"'More is better' seems to be the epitome of U.S. healthcare today, with doctors and patients often choosing to do more rather than less, even when there is no evidence to support it," noted Glantz. "But, as our study suggests, more may not always be better."

Glantz acknowledges that the optimal rate of any medical intervention is difficult to define, and that larger studies are needed to better understand the relationship between intervention and outcome. In the meantime, he believes it's hard to justify high rates of interventions especially elective in low-risk pregnant women without any known benefits to newborns, given that these interventions pose maternal risks.

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Contact: Emily Boynton
emily_boynton@urmc.rochester.edu
585-273-1757
University of Rochester Medical Center
Source:Eurekalert

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