The rise in singleton preterm births in the USA: the impact of labour induction
Article first published online: 13 AUG 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 119, Issue 11, pages 1309–1315, October 2012
How to Cite
Zhang, X. and Kramer, M. (2012), The rise in singleton preterm births in the USA: the impact of labour induction. BJOG: An International Journal of Obstetrics & Gynaecology, 119: 1309–1315. doi: 10.1111/j.1471-0528.2012.03453.x
- Issue published online: 14 SEP 2012
- Article first published online: 13 AUG 2012
- Accepted 20 June 2012. Published Online 13 August 2012.
- Caesarean delivery;
- labour induction;
- preterm birth
Please cite this paper as: Zhang X, Kramer M. The rise in singleton preterm births in the USA: the impact of labour induction. BJOG 2012;119:1309–1315.
Objective To assess the extent to which increased rates of labour induction and caesarean section have contributed to the recent rise in preterm birth.
Design National birth cohort study.
Population and sample Singleton live births, with primary analysis based on non-Hispanic white women.
Methods Ecological study based on the 50 states and the District of Columbia during two time periods 10 years apart: 1992–94 and 2002–04.
Main outcome measure Preterm birth (live birth <37 completed weeks of gestation), based on an algorithm combining menstrual and clinical estimates of gestational age.
Results The state-level ecological analysis among non-Hispanic white women showed that the change in preterm birth rate from 1992–94 to 2002–04 was significantly associated with the change in rate of labour induction (r = 0.50, 95% CI 0.26–0.68), but not with the change in rate of caesarean delivery (r = −0.06, 95% CI −0.33 to 0.22). Weaker but otherwise similar associations with labour induction were observed in Hispanic women and in non-Hispanic black women.
Conclusions Increasing use of labour induction is probably an important cause of the observed increased rate in preterm birth.