Temporal trends in late preterm and early term birthrates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions

Jennifer L. Richards, Michael S. Kramer, Paromita Deb-Rinker, Jocelyn Rouleau, Laust Mortensen, Mika Gissler, Nils Halvdan Morken, Rolv Skjarven, Sven Cnattingius, Stefan Johansson, Marie Delnord, Siobhan M. Dolan, Naho Morisaki, Suzanne Tough, Jennifer Zeitlin, Michael R. Kramer

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Importance Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. OBJECTIVE To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. DESIGN Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. EXPOSURES Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. MAIN OUTCOMES AND MEASURES Annual country-specific late preterm (34-36weeks) and early term (37-38 weeks) birth rates. RESULTS The study population included 2 415 432 Canadian births in 2006-2014 (4.8%late preterm; 25.3%early term); 305 947 Danish births in 2006-2010 (3.6%late preterm; 18.8% early term); 571 937 Finnish births in 2006-2015 (3.3%late preterm; 16.8%early term); 468 954 Norwegian births in 2006-2013 (3.8% late preterm; 17.2%early term); 737 754 Swedish births in 2006-2012 (3.6%late preterm; 18.7%early term); and 25 788 558 US births in 2006-2014 (6.0%late preterm; 26.9%early term). Late preterm birth rates decreased in Norway (3.9% to 3.5%) and the United States (6.8%to 5.7%). Early term birth rates decreased in Norway (17.6%to 16.8%), Sweden (19.4%to 18.5%), and the United States (30.2%to 24.4%). In the United States, early term birth rates decreased from 33.0%in 2006 to 21.1%in 2014 among births with clinician-initiated obstetric intervention, and from 29.7% in 2006 to 27.1%in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0%to 37.9%), Denmark (22.2%to 25.0%), and Finland (25.1%to 38.5%), and among early term births in Denmark (38.4%to 43.8%) and Finland (29.8%to 40.1%). CONCLUSIONS AND RELEVANCE Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth.

Original languageEnglish (US)
Pages (from-to)410-419
Number of pages10
JournalJAMA - Journal of the American Medical Association
Volume316
Issue number4
DOIs
StatePublished - Jul 26 2016

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Term Birth
North America
Birth Rate
Obstetrics
Parturition
Norway
Premature Birth
Denmark
Finland
Sweden
Induced Labor
Canada
Live Birth
Mothers

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Temporal trends in late preterm and early term birthrates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions. / Richards, Jennifer L.; Kramer, Michael S.; Deb-Rinker, Paromita; Rouleau, Jocelyn; Mortensen, Laust; Gissler, Mika; Morken, Nils Halvdan; Skjarven, Rolv; Cnattingius, Sven; Johansson, Stefan; Delnord, Marie; Dolan, Siobhan M.; Morisaki, Naho; Tough, Suzanne; Zeitlin, Jennifer; Kramer, Michael R.

In: JAMA - Journal of the American Medical Association, Vol. 316, No. 4, 26.07.2016, p. 410-419.

Research output: Contribution to journalArticle

Richards, JL, Kramer, MS, Deb-Rinker, P, Rouleau, J, Mortensen, L, Gissler, M, Morken, NH, Skjarven, R, Cnattingius, S, Johansson, S, Delnord, M, Dolan, SM, Morisaki, N, Tough, S, Zeitlin, J & Kramer, MR 2016, 'Temporal trends in late preterm and early term birthrates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions', JAMA - Journal of the American Medical Association, vol. 316, no. 4, pp. 410-419. https://doi.org/10.1001/jama.2016.9635
Richards, Jennifer L. ; Kramer, Michael S. ; Deb-Rinker, Paromita ; Rouleau, Jocelyn ; Mortensen, Laust ; Gissler, Mika ; Morken, Nils Halvdan ; Skjarven, Rolv ; Cnattingius, Sven ; Johansson, Stefan ; Delnord, Marie ; Dolan, Siobhan M. ; Morisaki, Naho ; Tough, Suzanne ; Zeitlin, Jennifer ; Kramer, Michael R. / Temporal trends in late preterm and early term birthrates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions. In: JAMA - Journal of the American Medical Association. 2016 ; Vol. 316, No. 4. pp. 410-419.
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abstract = "Importance Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. OBJECTIVE To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. DESIGN Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. EXPOSURES Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. MAIN OUTCOMES AND MEASURES Annual country-specific late preterm (34-36weeks) and early term (37-38 weeks) birth rates. RESULTS The study population included 2 415 432 Canadian births in 2006-2014 (4.8{\%}late preterm; 25.3{\%}early term); 305 947 Danish births in 2006-2010 (3.6{\%}late preterm; 18.8{\%} early term); 571 937 Finnish births in 2006-2015 (3.3{\%}late preterm; 16.8{\%}early term); 468 954 Norwegian births in 2006-2013 (3.8{\%} late preterm; 17.2{\%}early term); 737 754 Swedish births in 2006-2012 (3.6{\%}late preterm; 18.7{\%}early term); and 25 788 558 US births in 2006-2014 (6.0{\%}late preterm; 26.9{\%}early term). Late preterm birth rates decreased in Norway (3.9{\%} to 3.5{\%}) and the United States (6.8{\%}to 5.7{\%}). Early term birth rates decreased in Norway (17.6{\%}to 16.8{\%}), Sweden (19.4{\%}to 18.5{\%}), and the United States (30.2{\%}to 24.4{\%}). In the United States, early term birth rates decreased from 33.0{\%}in 2006 to 21.1{\%}in 2014 among births with clinician-initiated obstetric intervention, and from 29.7{\%} in 2006 to 27.1{\%}in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0{\%}to 37.9{\%}), Denmark (22.2{\%}to 25.0{\%}), and Finland (25.1{\%}to 38.5{\%}), and among early term births in Denmark (38.4{\%}to 43.8{\%}) and Finland (29.8{\%}to 40.1{\%}). CONCLUSIONS AND RELEVANCE Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth.",
author = "Richards, {Jennifer L.} and Kramer, {Michael S.} and Paromita Deb-Rinker and Jocelyn Rouleau and Laust Mortensen and Mika Gissler and Morken, {Nils Halvdan} and Rolv Skjarven and Sven Cnattingius and Stefan Johansson and Marie Delnord and Dolan, {Siobhan M.} and Naho Morisaki and Suzanne Tough and Jennifer Zeitlin and Kramer, {Michael R.}",
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TY - JOUR

T1 - Temporal trends in late preterm and early term birthrates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions

AU - Richards, Jennifer L.

AU - Kramer, Michael S.

AU - Deb-Rinker, Paromita

AU - Rouleau, Jocelyn

AU - Mortensen, Laust

AU - Gissler, Mika

AU - Morken, Nils Halvdan

AU - Skjarven, Rolv

AU - Cnattingius, Sven

AU - Johansson, Stefan

AU - Delnord, Marie

AU - Dolan, Siobhan M.

AU - Morisaki, Naho

AU - Tough, Suzanne

AU - Zeitlin, Jennifer

AU - Kramer, Michael R.

PY - 2016/7/26

Y1 - 2016/7/26

N2 - Importance Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. OBJECTIVE To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. DESIGN Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. EXPOSURES Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. MAIN OUTCOMES AND MEASURES Annual country-specific late preterm (34-36weeks) and early term (37-38 weeks) birth rates. RESULTS The study population included 2 415 432 Canadian births in 2006-2014 (4.8%late preterm; 25.3%early term); 305 947 Danish births in 2006-2010 (3.6%late preterm; 18.8% early term); 571 937 Finnish births in 2006-2015 (3.3%late preterm; 16.8%early term); 468 954 Norwegian births in 2006-2013 (3.8% late preterm; 17.2%early term); 737 754 Swedish births in 2006-2012 (3.6%late preterm; 18.7%early term); and 25 788 558 US births in 2006-2014 (6.0%late preterm; 26.9%early term). Late preterm birth rates decreased in Norway (3.9% to 3.5%) and the United States (6.8%to 5.7%). Early term birth rates decreased in Norway (17.6%to 16.8%), Sweden (19.4%to 18.5%), and the United States (30.2%to 24.4%). In the United States, early term birth rates decreased from 33.0%in 2006 to 21.1%in 2014 among births with clinician-initiated obstetric intervention, and from 29.7% in 2006 to 27.1%in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0%to 37.9%), Denmark (22.2%to 25.0%), and Finland (25.1%to 38.5%), and among early term births in Denmark (38.4%to 43.8%) and Finland (29.8%to 40.1%). CONCLUSIONS AND RELEVANCE Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth.

AB - Importance Clinicians have been urged to delay the use of obstetric interventions (eg, labor induction, cesarean delivery) until 39 weeks or later in the absence of maternal or fetal indications for intervention. OBJECTIVE To describe recent trends in late preterm and early term birth rates in 6 high-income countries and assess association with use of clinician-initiated obstetric interventions. DESIGN Retrospective analysis of singleton live births from 2006 to the latest available year (ranging from 2010 to 2015) in Canada, Denmark, Finland, Norway, Sweden, and the United States. EXPOSURES Use of clinician-initiated obstetric intervention (either labor induction or prelabor cesarean delivery) during delivery. MAIN OUTCOMES AND MEASURES Annual country-specific late preterm (34-36weeks) and early term (37-38 weeks) birth rates. RESULTS The study population included 2 415 432 Canadian births in 2006-2014 (4.8%late preterm; 25.3%early term); 305 947 Danish births in 2006-2010 (3.6%late preterm; 18.8% early term); 571 937 Finnish births in 2006-2015 (3.3%late preterm; 16.8%early term); 468 954 Norwegian births in 2006-2013 (3.8% late preterm; 17.2%early term); 737 754 Swedish births in 2006-2012 (3.6%late preterm; 18.7%early term); and 25 788 558 US births in 2006-2014 (6.0%late preterm; 26.9%early term). Late preterm birth rates decreased in Norway (3.9% to 3.5%) and the United States (6.8%to 5.7%). Early term birth rates decreased in Norway (17.6%to 16.8%), Sweden (19.4%to 18.5%), and the United States (30.2%to 24.4%). In the United States, early term birth rates decreased from 33.0%in 2006 to 21.1%in 2014 among births with clinician-initiated obstetric intervention, and from 29.7% in 2006 to 27.1%in 2014 among births without clinician-initiated obstetric intervention. Rates of clinician-initiated obstetric intervention increased among late preterm births in Canada (28.0%to 37.9%), Denmark (22.2%to 25.0%), and Finland (25.1%to 38.5%), and among early term births in Denmark (38.4%to 43.8%) and Finland (29.8%to 40.1%). CONCLUSIONS AND RELEVANCE Between 2006 and 2014, late preterm and early term birth rates decreased in the United States, and an association was observed between early term birth rates and decreasing clinician-initiated obstetric interventions. Late preterm births also decreased in Norway, and early term births decreased in Norway and Sweden. Clinician-initiated obstetric interventions increased in some countries but no association was found with rates of late preterm or early term birth.

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