ResearchObstetricsTrends in cesarean delivery at preterm gestation and association with perinatal mortality
Section snippets
Materials and Methods
We utilized the US-linked natality and infant deaths data files composed of births from 1990 through 2004, and the corresponding fetal death files for the same period. These data files correspond to data abstracted from birth certificates of live-born infants and from fetal and infant death certificates and assembled by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention.17 Infant deaths from 1992 through 1994 were not linked to the corresponding
Temporal changes in preterm cesarean deliveries and perinatal mortality
Temporal trends in rates of preterm cesarean delivery from 1990 through 2004 and the corresponding relative changes in rates with 1990 as the base period are shown in Figure 1. Relative to the rates in 1990, preterm cesarean delivery increased by 37% (25.5% in 1990 to 35.0% in 2004). This increase in preterm cesarean was greatest at 24-27 weeks (Table 1). There was an overall 20.2% decline in preterm stillbirths from 1990 through 2004 (Figure 2); however, the greatest decline occurred at 34-36
Comment
This large population-based study of singleton preterm births in the United States shows that the steep temporal increase in preterm cesarean deliveries appears to be favorably associated with a concurrent decline in preterm stillbirth and early neonatal mortality. For instance, the increase in cesarean deliveries from 1990 through 2004 by 47.6% at 24-27 weeks, 31.7% at 28-33 weeks, and 28.9% at 34-36 weeks was associated with an 11.4%, 4.9%, and 0.6% decline in perinatal mortality rates at
References (33)
- et al.
Cesarean delivery in the developing world
Clin Perinatol
(2008) - et al.
Population trends in cesarean delivery for breech presentation in the United States, 1997-2003
Am J Obstet Gynecol
(2008) - et al.
The influence of mode of delivery on twin neonatal mortality in the US: variance by birth weight discordance
Am J Obstet Gynecol
(2005) - et al.
Racial and ethnic disparities in the trends in primary cesarean delivery based on indications
Am J Obstet Gynecol
(2009) - et al.
The relationship between cesarean delivery and gestational age among US singleton births
Clin Perinatol
(2008) - et al.
Maternal-fetal conditions necessitating a medical intervention resulting in preterm birth
Am J Obstet Gynecol
(2006) - et al.
Chronic hypertension and risk of placental abruption: is the association modified by ischemic placental disease?
Am J Obstet Gynecol
(2007) - et al.
Medically indicated preterm birth: recognizing the importance of the problem
Clin Perinatol
(2008) - et al.
Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination
Am J Obstet Gynecol
(2002) - et al.
Recent trends in cesarean delivery in the United States
NCHS Data Brief
(2010)
Trends in cesarean rates for first births and repeat cesarean rates for low-risk women: United States, 1990-2003
Natl Vital Stat Rep
Infant and neonatal mortality for primary cesarean and vaginal births to women with ”no indicated risk,” United States, 1998-2001 birth cohorts
Birth
Method of delivery and neonatal mortality among very low birth weight infants in the United States
Matern Child Health J
Secular trends in cesarean delivery rates among macrosomic deliveries in the United States, 1989 to 2002
J Perinatol
Mode of delivery and the risk of delivery-related perinatal death among twins at term: a retrospective cohort study of 8073 births
BJOG
Changes in indications for cesarean delivery: United States, 1985 and 1994
Am J Public Health
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Cite this article as: Ananth CV, Vintzileos AM. Trends in cesarean delivery at preterm gestation and association with perinatal mortality. Am J Obstet Gynecol 2011;204:505.e1-8.