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

, Glantz focused on pregnant women delivering in level I hospitals those lacking a Neonatal Intensive Care Unit or NICU because they care primarily for low-risk women who do not have major complications, such as diabetes, high blood pressure or other severe disease. The majority of women in the United States deliver in level I hospitals.

Through a birth certificate database, Glantz obtained and analyzed data from 10 level I hospitals in the Finger Lakes Region of upstate New York and calculated the rates of induction and cesarean delivery at each between 2004 and 2008. Not surprisingly, the rates varied widely.

To determine the health of newborns delivered at these hospitals, he looked at three outcomes: transfer of the newborn to a hospital with a NICU (signifying the presence of complications that required a higher level of care); immediate ventilation or breathing assistance; and a low 5-minute Apgar score (a quick assessment of the overall wellbeing of a newborn).

Using statistical models, Glantz assessed the relationship between rates of induction and cesarean delivery and rates of the three neonatal outcomes. He found intervention rates had no consistent effect on newborns: Whether a hospital did a lot or very few interventions, there was no association with how sick or healthy the infants were.

Even after a second round of analysis that accounted for differences among pregnant women that could potentially impact the results, the finding was the same hospitals with high intervention rates had newborn outcomes indistinguishable from hospitals with low rates.

According to Glantz, "If higher intervention rates were preventing negative outcomes that otherwise would have occurred, and lower intervention rates led to negative outcomes that potentially could have been avoided, the data would have revealed these relationships, but there were no such trends."

The study included a group of approximately 28,
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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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