Evidence of overuse? Patterns of obstetric interventions during labour and birth among Australian mothers

Fox, Haylee; Callander, Emily; Lindsay, Daniel; Topp, Stephanie M.

doi:10.1186/s12884-019-2369-5

Cited by 24 publications

(20 citation statements)

References 43 publications

(54 reference statements)

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“…The fact that nearly half of all records did not report on labour onset (and thus labour length) was unexpected, the consequences of which are seen in the large discrepancy between recall and actual events for this variable. This is a critical omission, as length of labour is an important trigger for routine labour interventions [38] . Moreover, it limited our ability to assess the level of agreement with precision.…”

Section: Discussionmentioning

confidence: 99%

Agreement between maternal recall of distant first birth events with hospital birth records: A cohort study

Ebrahimoff¹

2021

Preprint

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BACKGROUND Inter and intra-generational birth cohorts could be particularly useful for predicting the likelihood of labour and birth events for nulliparous women. However, maternal recall of their first childbirth may be imprecise, and hospital records can be inaccurate. Establishing the extent of agreement between mothers’ recall and hospital reports of historical first birth events could be the basis of a prediction tool that could contribute to better health care practices during daughter’s perinatal period. METHODS In 2015, women who had their first baby between 1967 and 1997 were asked to recall gravidity, method of labour onset, type of pain relief, length of labour, birth outcome, and infant’s gender, birthweight and gestational age ≥17 years postpartum. Responses were compared to hospital birth records. Agreement was evaluated using Bland-Altman’s plots and Kappa statistics (k). Logistic regression modeling was used to determine factors influencing discrepant recall. RESULTS Of 150 questionnaires distributed, 101 records were complete. Up to 49 years after birth there was strong agreement for birthweight measured at interval (mean discrepancy -28.69g, SD =170.91g, Bland-Altman 95% limits of agreement (-363.66g, 306.28g)) and category level birthweight k=0.83, good agreement for gestational age (GA) in weeks, at interval level (mean difference=0, SD =0.90, Bland-Altman 95% limits of agreement (-1.766, 1.766)) and at category level GA k=0.56. There was moderate agreement for labour length (≤10hrs/>10hrs) k=0.54; 43% of records did not record this information. For gravidity k=0.43, labour onset k=0.79; any pain relief k=0.61; and birth outcome k=0.91. Univariate logistic regression showed better agreement on infant birthweight in women with higher levels of education, lower agreement for onset of labour method with increasing maternal age at birth, and higher agreement for use of pethidine, but lower agreement for use of epidural in women who had their first babies more recently. CONCLUSIONS Mothers accounts of first birth events generally agree with hospital records. Familial birth data may contribute to more individualised care for nulliparous women, and may limit rising interventions based on population level guidelines. Future research in other settings is warranted before diagnostic criteria may be used in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Agreement between maternal recall of distant first birth events with hospital birth records: A cohort study

Ebrahimoff¹

2021

Preprint

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“…35 36 Concerns have been raised in many studies about the increasing trend of multiple pregnancy reported both in China and worldwide, which was associated with the global rise in advanced maternal age, infertility treatments and obstetric interventions performed before 37 gestational weeks, especially at 34-36 weeks. [37][38][39][40][41] on November 1, 2020 by guest. Protected by copyright.…”

Section: Discussionmentioning

confidence: 99%

Ten-year time trends in preterm birth during a sociodemographic transition period: a retrospective cohort study in Shenzhen, China

Luo

Wang

et al. 2020

BMJ Open

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ObjectivesTo investigate time trends of preterm birth and estimate the contributions of risk factors to the changes in preterm birth rates over a decade (2009–2018) of transitional period in Shenzhen, China.DesignRetrospective cohort study between 2009 and 2018.SettingAll births in Baoan during January 2009 and December 2018 registered in the Shenzhen Birth Registry Database.Participants478 044 live births were included with sociodemographic and medical records for both women and infants.Outcome measuresThe incidence rate of preterm birth stratified by different maternal and infant characteristics. Multiple logistic regression was used to identify significant risk factors associated with preterm birth. The population attributable risk fraction of each factor was calculated to estimate its contribution to variations of preterm birth rate over the 10 years.ResultsA total of 27 829 preterm births from 478 044 (5.8%) live births were recorded and the preterm birth rate increased from 5.5% in 2009 to 6.2% in 2018. Medically induced preterm birth rate increased from 2.0% in 2009 to 3.4% in 2018 while spontaneous preterm labour rate decreased from 3.3% to 2.7% over the decade years. Risk factors including multiple pregnancy (0.28% increase) drove the rise of preterm birth rate, whereas changes in maternal educational attainment (0.22% reduction) and prenatal care utilisation (0.45% reduction) had contributed to the decline in preterm birth rate.ConclusionsAn uptrend of preterm birth rate was observed in an area under rapid sociodemographic transitions during 2009–2018 and the changes were associated with these sociodemographic transitions. Continued investments in girls’ education and prenatal care have the potential of reducing preterm birth rate.

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“…This contrasted with higher use of inpatient contacts in the other large cities with similar risk profiles. The time period of the present analysis included decreasing mortality in healthy Danish children, and steady total use but increased specialisation of health services [5,8,9]. Thus, a focused comparison of the organisation of the health system responsible for referral and admission of ill, but basically healthy children in the four major urban areas in Denmark could be useful: perhaps Copenhagen admit too many children or, alternatively, Aarhus admit too few.…”

Section: Plos Onementioning

confidence: 99%

“…However, socioeconomic inequalities in child mortality persist between and within countries [2,3]. Denmark is a high-income country, but even in the Danish setting inequality may be present despite free access to health services, since more resourceful citizens may be better at seeking health services, or the health care system may not prioritise according to the need of the citizens [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The match between need and use of health services among healthy under-fives in Denmark: A register-based national cohort study

Jensen

Andersen

et al. 2020

PLoS ONE

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To study a potential positive association (referred to as 'a match') between the need for health service (expressed by a mortality risk score) and observed health service utilisation among healthy Danish under-fives. Further, municipal differences in the match were examined to motivate focused comparisons between the organisation of regional health services. Design Register-based national cohort study. Participants The population of 1,246,599 Danish children born 1997-2016 who survived until date of first discharge to the home after birth without a diagnosis of severe chronic disease. Main outcome measures Hazard ratios (HR) for a doubling of the mortality rate were calculated for the following health services: total contacts, inpatient contacts (admission > 1 day), outpatient contacts, general practitioner contacts, specialist contacts, medication use, and vaccinations. Results The use of total contacts, inpatient contacts (> 1 day) and general practitioner contacts as well as medication matched with the mortality risk score, HRs between 1.027 (1.026 to 1.028) and 1.111 (1.108 to 1.113), whereas outpatient and specialist contacts as well as vaccinations did not, HRs between 0.913 (0.912 to 0.915) and 0.991 (0.991 to 0.991). There were some remarkable differences among the 98 Danish municipalities.

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Evidence of overuse? Patterns of obstetric interventions during labour and birth among Australian mothers

Cited by 24 publications

References 43 publications

Agreement between maternal recall of distant first birth events with hospital birth records: A cohort study

Agreement between maternal recall of distant first birth events with hospital birth records: A cohort study

Ten-year time trends in preterm birth during a sociodemographic transition period: a retrospective cohort study in Shenzhen, China

The match between need and use of health services among healthy under-fives in Denmark: A register-based national cohort study

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