Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study.
BACKGROUND:Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. METHODS AND FINDINGS:In this m...
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ftdoajarticles:oai:doaj.org/article:893ee1aaa8f8450393154ee10c6bce08 2023-05-15T16:49:10+02:00 Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. Anna E Seijmonsbergen-Schermers Thomas van den Akker Eva Rydahl Katrien Beeckman Annick Bogaerts Lorena Binfa Lucy Frith Mechthild M Gross Björn Misselwitz Berglind Hálfdánsdóttir Deirdre Daly Paul Corcoran Jean Calleja-Agius Neville Calleja Miriam Gatt Anne Britt Vika Nilsen Eugene Declercq Mika Gissler Anna Heino Helena Lindgren Ank de Jonge 2020-05-01T00:00:00Z https://doi.org/10.1371/journal.pmed.1003103 https://doaj.org/article/893ee1aaa8f8450393154ee10c6bce08 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pmed.1003103 https://doaj.org/toc/1549-1277 https://doaj.org/toc/1549-1676 1549-1277 1549-1676 doi:10.1371/journal.pmed.1003103 https://doaj.org/article/893ee1aaa8f8450393154ee10c6bce08 PLoS Medicine, Vol 17, Iss 5, p e1003103 (2020) Medicine R article 2020 ftdoajarticles https://doi.org/10.1371/journal.pmed.1003103 2022-12-31T07:33:15Z BACKGROUND:Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. METHODS AND FINDINGS:In this multinational cross-sectional study, existing data on 4,729,307 singleton births at ≥37 weeks in 2013 from Finland, Sweden, Norway, Denmark, Iceland, Ireland, England, the Netherlands, Belgium, Germany (Hesse), Malta, the United States, and Chile were used to describe variations in childbirth interventions and outcomes. Numbers of births ranged from 3,987 for Iceland to 3,500,397 for the USA. Crude data were analysed in the Netherlands, or analysed data were shared with the principal investigator. Strict variable definitions were used and information on data quality was collected. Intervention rates were described for each country and stratified by parity. Uni- and multivariable analyses were performed, adjusted for population characteristics, and associations between rates of interventions, population characteristics, and outcomes were assessed using Spearman's rank correlation coefficients. Considerable intercountry variations were found for all interventions, despite adjustments for population characteristics. Adjustments for ethnicity and body mass index changed odds ratios for augmentation of labour and episiotomy. Largest variations were found for augmentation of labour, pain relief, episiotomy, instrumental birth, and cesarean section (CS). Percentages of births at ≥42 weeks varied from 0.1% to 6.7%. Rates among nulliparous versus multiparous women varied from 56% to 80% versus 51% to 82% for spontaneous onset of labour; 14% to 36% versus 8% to 28% for induction of labour; 3% to 13% versus 7% to 26% for prelabour CS; 16% to 48% versus 12% to 50% for overall CS; 22% to 71% versus 7% to 38% for augmentation of labour; 50% to 93% versus 25% to 86% for any intrapartum pain relief, 19% to 83% versus 10% to 64% for ... Article in Journal/Newspaper Iceland Directory of Open Access Journals: DOAJ Articles Norway PLOS Medicine 17 5 e1003103 |
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English |
topic |
Medicine R |
spellingShingle |
Medicine R Anna E Seijmonsbergen-Schermers Thomas van den Akker Eva Rydahl Katrien Beeckman Annick Bogaerts Lorena Binfa Lucy Frith Mechthild M Gross Björn Misselwitz Berglind Hálfdánsdóttir Deirdre Daly Paul Corcoran Jean Calleja-Agius Neville Calleja Miriam Gatt Anne Britt Vika Nilsen Eugene Declercq Mika Gissler Anna Heino Helena Lindgren Ank de Jonge Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
topic_facet |
Medicine R |
description |
BACKGROUND:Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. METHODS AND FINDINGS:In this multinational cross-sectional study, existing data on 4,729,307 singleton births at ≥37 weeks in 2013 from Finland, Sweden, Norway, Denmark, Iceland, Ireland, England, the Netherlands, Belgium, Germany (Hesse), Malta, the United States, and Chile were used to describe variations in childbirth interventions and outcomes. Numbers of births ranged from 3,987 for Iceland to 3,500,397 for the USA. Crude data were analysed in the Netherlands, or analysed data were shared with the principal investigator. Strict variable definitions were used and information on data quality was collected. Intervention rates were described for each country and stratified by parity. Uni- and multivariable analyses were performed, adjusted for population characteristics, and associations between rates of interventions, population characteristics, and outcomes were assessed using Spearman's rank correlation coefficients. Considerable intercountry variations were found for all interventions, despite adjustments for population characteristics. Adjustments for ethnicity and body mass index changed odds ratios for augmentation of labour and episiotomy. Largest variations were found for augmentation of labour, pain relief, episiotomy, instrumental birth, and cesarean section (CS). Percentages of births at ≥42 weeks varied from 0.1% to 6.7%. Rates among nulliparous versus multiparous women varied from 56% to 80% versus 51% to 82% for spontaneous onset of labour; 14% to 36% versus 8% to 28% for induction of labour; 3% to 13% versus 7% to 26% for prelabour CS; 16% to 48% versus 12% to 50% for overall CS; 22% to 71% versus 7% to 38% for augmentation of labour; 50% to 93% versus 25% to 86% for any intrapartum pain relief, 19% to 83% versus 10% to 64% for ... |
format |
Article in Journal/Newspaper |
author |
Anna E Seijmonsbergen-Schermers Thomas van den Akker Eva Rydahl Katrien Beeckman Annick Bogaerts Lorena Binfa Lucy Frith Mechthild M Gross Björn Misselwitz Berglind Hálfdánsdóttir Deirdre Daly Paul Corcoran Jean Calleja-Agius Neville Calleja Miriam Gatt Anne Britt Vika Nilsen Eugene Declercq Mika Gissler Anna Heino Helena Lindgren Ank de Jonge |
author_facet |
Anna E Seijmonsbergen-Schermers Thomas van den Akker Eva Rydahl Katrien Beeckman Annick Bogaerts Lorena Binfa Lucy Frith Mechthild M Gross Björn Misselwitz Berglind Hálfdánsdóttir Deirdre Daly Paul Corcoran Jean Calleja-Agius Neville Calleja Miriam Gatt Anne Britt Vika Nilsen Eugene Declercq Mika Gissler Anna Heino Helena Lindgren Ank de Jonge |
author_sort |
Anna E Seijmonsbergen-Schermers |
title |
Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
title_short |
Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
title_full |
Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
title_fullStr |
Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
title_full_unstemmed |
Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
title_sort |
variations in use of childbirth interventions in 13 high-income countries: a multinational cross-sectional study. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pmed.1003103 https://doaj.org/article/893ee1aaa8f8450393154ee10c6bce08 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
PLoS Medicine, Vol 17, Iss 5, p e1003103 (2020) |
op_relation |
https://doi.org/10.1371/journal.pmed.1003103 https://doaj.org/toc/1549-1277 https://doaj.org/toc/1549-1676 1549-1277 1549-1676 doi:10.1371/journal.pmed.1003103 https://doaj.org/article/893ee1aaa8f8450393154ee10c6bce08 |
op_doi |
https://doi.org/10.1371/journal.pmed.1003103 |
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PLOS Medicine |
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17 |
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5 |
container_start_page |
e1003103 |
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