This was on the internet news today.
Pat Gima, IBCLC
Milwaukee, Wisconsin
Health - Reuters
Troubling Rise in Induced Labor During 1990s: Study
Wed Aug 28, 5:49 PM ET
By Melissa Schorr
NEW YORK (Reuters Health) - The rate of induced labor among pregnant women
in the US has doubled in the past decade, government researchers report.
"We found a large increase in the percentage of births that had induced
labor," study author Dr. Marian MacDorman, of the National Center for
Health Statistics in Hyattsville, Maryland, told Reuters Health.
Traditionally, labor induction has been advised for only certain reasons,
such as when a medical condition endangers the mother or fetus, or in some
instances where pregnancy runs longer than 42 weeks. But recent research
has indicated that elective labor induction, for medical reasons or just
convenience, is on the rise.
To further examine US trends, MacDorman and colleagues used vital
statistics to track all births nationally from 1989 to 1998. They found
that the percentage of births among US women that were initiated using some
form of medical intervention rose from 9% in 1989 to just over 19% by 1998.
The findings are published in the August issue of the journal Pediatric and
Perinatal Epidemiology. They mirror another analysis by researchers from
the National Institutes of Health ( news - web sites), which found rates of
induction for medical reasons grew more slowly than for induced labor
overall.
Looking at the stages of pregnancy in which labor was induced, the
researchers found that the rate among women whose pregnancies were longer
than normal--or "post-term"--rose from 14.5% in 1989 to 23.8% by 1998.
And among all post-term births, the risk of infant death was 23% lower when
labor was induced, according to the researchers.
But there was also a sharp increase in the rate of induced pre-term labor,
which rose from 6.7% to 13.4% during the study period.
This may help explain the concerning rise of pre-term births among
non-Hispanic white women in the US, MacDorman said. This increase in
premature delivery has been partly attributed to various causes, such as
the rise in multiple births aided by assisted reproductive technologies.
MacDorman estimated that a significant amount of the increase in pre-term
births among white US women is due to induced labors.
"Pre-term babies are more likely to be born at low birth weight and have
medical complications, so that's something we should be concerned about,"
she noted.
Moreover, whether these inductions are always advisable is unclear.
MacDorman's team found that only around half of the pre-term inductions had
an identifiable medical reason listed on the birth certificate.
In addition, the investigators found that social, economic and ethnic
factors influence whether women receive an induction. Women who were white
or Native American, highly educated, or having their first pregnancy were
found to be more likely to receive an induction.
Because of these variations in the use of induction and the possible health
risks to the child from earlier delivery, MacDorman suggested that some
women may need to question advice to receive an induction.
"If I had a doctor that wanted to induce pre-term, below 40 weeks, I'd get
a second opinion," she said. "It's a medical intervention, and there's
certain risks. We should be asking, 'Is it really necessary to do it that
often?"'
SOURCE: Pediatric and Perinatal Epidemiology 2002;16:263-273.
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