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...
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Online Access: | http://hdl.handle.net/10147/629741 https://doi.org/10.1371/journal.pmed.1003103 |
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ftlenus:oai:www.lenus.ie:10147/629741 2024-06-09T07:47:08+00:00 Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. Seijmonsbergen-Schermers, Anna E van den Akker, Thomas Rydahl, Eva Beeckman, Katrien Bogaerts, Annick Binfa, Lorena Frith, Lucy Gross, Mechthild M Misselwitz, Björn Hálfdánsdóttir, Berglind Daly, Deirdre Corcoran, Paul Calleja-Agius, Jean Calleja, Neville Gatt, Miriam Vika Nilsen, Anne Britt Declercq, Eugene Gissler, Mika Heino, Anna Lindgren, Helena de Jonge, Ank 2020-05-22 http://hdl.handle.net/10147/629741 https://doi.org/10.1371/journal.pmed.1003103 en eng 32442207 doi:10.1371/journal.pmed.1003103 http://hdl.handle.net/10147/629741 1549-1676 PLoS medicine PLoS medicine 17 5 e1003103 United States CHILDBIRTH POPULATION HEALTH HEALTH OUTCOMES Article Other 2020 ftlenus https://doi.org/10.1371/journal.pmed.1003103 2024-05-16T08:05:32Z 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 Lenus - Irish Health Publications Archive (HSE - Health Service Executive) Norway PLOS Medicine 17 5 e1003103 |
institution |
Open Polar |
collection |
Lenus - Irish Health Publications Archive (HSE - Health Service Executive) |
op_collection_id |
ftlenus |
language |
English |
topic |
CHILDBIRTH POPULATION HEALTH HEALTH OUTCOMES |
spellingShingle |
CHILDBIRTH POPULATION HEALTH HEALTH OUTCOMES Seijmonsbergen-Schermers, Anna E van den Akker, Thomas Rydahl, Eva Beeckman, Katrien Bogaerts, Annick Binfa, Lorena Frith, Lucy Gross, Mechthild M Misselwitz, Björn Hálfdánsdóttir, Berglind Daly, Deirdre Corcoran, Paul Calleja-Agius, Jean Calleja, Neville Gatt, Miriam Vika Nilsen, Anne Britt Declercq, Eugene Gissler, Mika Heino, Anna Lindgren, Helena de Jonge, Ank Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. |
topic_facet |
CHILDBIRTH POPULATION HEALTH HEALTH OUTCOMES |
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 |
Seijmonsbergen-Schermers, Anna E van den Akker, Thomas Rydahl, Eva Beeckman, Katrien Bogaerts, Annick Binfa, Lorena Frith, Lucy Gross, Mechthild M Misselwitz, Björn Hálfdánsdóttir, Berglind Daly, Deirdre Corcoran, Paul Calleja-Agius, Jean Calleja, Neville Gatt, Miriam Vika Nilsen, Anne Britt Declercq, Eugene Gissler, Mika Heino, Anna Lindgren, Helena de Jonge, Ank |
author_facet |
Seijmonsbergen-Schermers, Anna E van den Akker, Thomas Rydahl, Eva Beeckman, Katrien Bogaerts, Annick Binfa, Lorena Frith, Lucy Gross, Mechthild M Misselwitz, Björn Hálfdánsdóttir, Berglind Daly, Deirdre Corcoran, Paul Calleja-Agius, Jean Calleja, Neville Gatt, Miriam Vika Nilsen, Anne Britt Declercq, Eugene Gissler, Mika Heino, Anna Lindgren, Helena de Jonge, Ank |
author_sort |
Seijmonsbergen-Schermers, Anna E |
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. |
publishDate |
2020 |
url |
http://hdl.handle.net/10147/629741 https://doi.org/10.1371/journal.pmed.1003103 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
PLoS medicine 17 5 e1003103 United States |
op_relation |
32442207 doi:10.1371/journal.pmed.1003103 http://hdl.handle.net/10147/629741 1549-1676 PLoS medicine |
op_doi |
https://doi.org/10.1371/journal.pmed.1003103 |
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PLOS Medicine |
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17 |
container_issue |
5 |
container_start_page |
e1003103 |
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1801378049837498368 |