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Shifting Patterns in Cesarean Delivery Scheduling and Timing in Oregon before and after a Statewide Hard Stop Policy.
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- Author(s): Muoto, Ifeoma; Darney, Blair G.; Lau, Bernard; Cheng, Yvonne W.; Tomlinson, Mark W.; Neilson, Jr., Duncan R.; Friedman, Steven A.; Rogovoy, Joanne; Caughey, Aaron B.; Snowden, Jonathan M.; Neilson, Duncan R Jr
- Source:
Health Services Research; Aug2018 Supplement 1, Vol. 53, p2839-2857, 19p, 1 Diagram, 3 Charts, 1 Graph- Subject Terms:
CESAREAN section; HEALTH policy; OBSTETRICS; GYNECOLOGY; MATERNAL health services; AGE distribution; ARTIFICIAL respiration; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; NEONATAL intensive care; RESEARCH; RESEARCH funding; ELECTIVE surgery; TIME; TIME series analysis; LOGISTIC regression analysis; SOCIOECONOMIC factors; EVALUATION research; NEONATAL intensive care units; RETROSPECTIVE studies - Source:
- Additional Information
- Subject Terms:
- Abstract:
Objectives: To assess the use and timing of scheduled cesareans and other categories of cesarean delivery and the prevalence of neonatal morbidity among cesareans in Oregon before and after the implementation of Oregon's statewide policy limiting elective early deliveries.Data Sources: Oregon vital statistics records, 2008-2013.Study Design: Retrospective cohort study, with multivariable logistic regression, regression controlling for time trends, and interrupted time series analyses, to compare the odds of different categories of cesarean delivery and the odds of neonatal morbidity pre- and postpolicy.Data Collection/extraction Methods: We analyzed vital statistics data on all term births in Oregon (2008-2013), excluding births in 2011.Principal Findings: The odds of early-term scheduled cesareans decreased postpolicy (adjusted odds ratio [aOR], 0.70; 95 percent confidence interval [CI], 0.66-0.74). In the postpolicy period, there were mixed findings regarding assisted neonatal ventilation and neonatal intensive care unit admission, with regression models indicating higher postpolicy odds in some categories, but lower postpolicy odds after controlling for time trends.Conclusions: Oregon's hard stop policy limiting elective early-term cesarean delivery was associated with lower odds of cesarean delivery in the category of women who were targeted by the policy; more research is needed on impact of such policies on neonatal outcomes. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Health Services Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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