Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland
Abstract Background Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. Methods The study was based on nationwide data from the Icelandi...
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crwiley:10.1111/birt.12353 2024-04-28T08:26:07+00:00 Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland Swift, Emma M. Tomasson, Gunnar Gottfreðsdóttir, Helga Einarsdóttir, Kristjana Zoega, Helga University of Iceland Research Fund 2018 http://dx.doi.org/10.1111/birt.12353 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fbirt.12353 https://onlinelibrary.wiley.com/doi/pdf/10.1111/birt.12353 en eng Wiley http://onlinelibrary.wiley.com/termsAndConditions#vor Birth volume 45, issue 4, page 368-376 ISSN 0730-7659 1523-536X Obstetrics and Gynecology journal-article 2018 crwiley https://doi.org/10.1111/birt.12353 2024-04-08T06:52:21Z Abstract Background Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. Methods The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995‐2014. Change over time was expressed as relative risk ( RR ), using Poisson regression with 95% confidence intervals ( CI ) adjusted for several maternal and pregnancy‐related characteristics. Analyses were stratified by women's parity and diagnosis of diabetes or hypertensive disorder. Results During the study period, there were 81 389 intended vaginal births and 5544 elective cesarean deliveries. Among both primiparous and multiparous women, we observed a marked increase across time for labor induction (RR 1.78 [CI 1.67‐1.91] and RR 1.83 [CI 1.73‐1.93], respectively) and epidural analgesia (RR 1.40 [CI 1.36‐1.45] and RR 1.74 [CI 1.66‐1.83], respectively). A similar trend of smaller magnitude was observed among women with hypertensive disorders but no time trend was observed among women with diabetes. Incidence of cesarean and instrumental delivery remained stable across time. Discussion The use of labor induction and epidural analgesia increased considerably over time, while the cesarean delivery rate remained low and stable. Increases in labor induction and epidural analgesia were most pronounced for women without a diagnosis of diabetes or hypertensive disorder and were not explained by maternal characteristics such as advanced age. Article in Journal/Newspaper Iceland Wiley Online Library Birth 45 4 368 376 |
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Obstetrics and Gynecology |
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Obstetrics and Gynecology Swift, Emma M. Tomasson, Gunnar Gottfreðsdóttir, Helga Einarsdóttir, Kristjana Zoega, Helga Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
topic_facet |
Obstetrics and Gynecology |
description |
Abstract Background Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. Methods The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995‐2014. Change over time was expressed as relative risk ( RR ), using Poisson regression with 95% confidence intervals ( CI ) adjusted for several maternal and pregnancy‐related characteristics. Analyses were stratified by women's parity and diagnosis of diabetes or hypertensive disorder. Results During the study period, there were 81 389 intended vaginal births and 5544 elective cesarean deliveries. Among both primiparous and multiparous women, we observed a marked increase across time for labor induction (RR 1.78 [CI 1.67‐1.91] and RR 1.83 [CI 1.73‐1.93], respectively) and epidural analgesia (RR 1.40 [CI 1.36‐1.45] and RR 1.74 [CI 1.66‐1.83], respectively). A similar trend of smaller magnitude was observed among women with hypertensive disorders but no time trend was observed among women with diabetes. Incidence of cesarean and instrumental delivery remained stable across time. Discussion The use of labor induction and epidural analgesia increased considerably over time, while the cesarean delivery rate remained low and stable. Increases in labor induction and epidural analgesia were most pronounced for women without a diagnosis of diabetes or hypertensive disorder and were not explained by maternal characteristics such as advanced age. |
author2 |
University of Iceland Research Fund |
format |
Article in Journal/Newspaper |
author |
Swift, Emma M. Tomasson, Gunnar Gottfreðsdóttir, Helga Einarsdóttir, Kristjana Zoega, Helga |
author_facet |
Swift, Emma M. Tomasson, Gunnar Gottfreðsdóttir, Helga Einarsdóttir, Kristjana Zoega, Helga |
author_sort |
Swift, Emma M. |
title |
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
title_short |
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
title_full |
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
title_fullStr |
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
title_full_unstemmed |
Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland |
title_sort |
obstetric interventions, trends, and drivers of change: a 20‐year population‐based study from iceland |
publisher |
Wiley |
publishDate |
2018 |
url |
http://dx.doi.org/10.1111/birt.12353 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fbirt.12353 https://onlinelibrary.wiley.com/doi/pdf/10.1111/birt.12353 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Birth volume 45, issue 4, page 368-376 ISSN 0730-7659 1523-536X |
op_rights |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
op_doi |
https://doi.org/10.1111/birt.12353 |
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Birth |
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45 |
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4 |
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368 |
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376 |
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1797585641949626368 |