Indications for labor induction. Differences between university and community hospitals.
OBJECTIVE
To compare the rates of and indications for labor induction between a university hospital and two community hospitals and to examine the risk of cesarean delivery among labor induction cases.


METHODS
Labor induction cases over a six-month period were included (N = 536). Medical records were reviewed by a trained abstractor using a standardized form to determine maternal characteristics, reason for induction and perinatal outcomes.


RESULTS
Rates of labor induction were significantly different between the three hospitals: university, 18.2%; community hospital A, 21.4%; community hospital B, 33.7% (P < .001). At the university hospital, 95% of labor inductions were medically indicated using American College of Obstetricians and Gynecologists (ACOG) criteria. Forty-four percent of labor inductions at community hospital A and 57% at community hospital B were for elective reasons. Cesarean rates among induction cases were highest at the university hospital (19%) as compared to community hospital A (15%) and community hospital B (11%), although the difference was not statistically significant. Parity, race and cervical status, but not elective induction, were significantly associated with cesarean delivery.


CONCLUSIONS
Labor induction was more frequent in community hospitals but more likely to meet ACOG-approved indications at the university hospital. The more-frequent inductions at the community hospitals did not result in higher cesarean rates.
Beebe
L A
LA
Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center 73190, USA. laura-beebe@ouhsc.edu
Rayburn
W F
WF
Beaty
C M
CM
Eberly
K L
KL
Stanley
J R
JR
Rayburn
L A
LA
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data*; D008499:Medical Records; D009825:Oklahoma / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies