title: Assisted delivery in the teenage population: the effect of inter-hospital variation, deprivation, and age.
abstract: The objective was to determine the relationship between the risk of assisted delivery in women aged under 20 years and place of treatment, deprivation and age.
  
  
  METHODS
  Cross sectional survey utilising routinely collected hospitals admissions data.
  
  
  METHODS
  Teenagers (women aged under 20 years) whose delivery resulted in a hospital admission in the period April 1st 1994 to March 31st 1997 in the Trent Health Region of England.
  
  
  METHODS
  The cases were identified using Office of Population Census and Surveys procedural codes, and International Classification of Diseases diagnostic codes associated with delivery. Variables collected included type of delivery, age at delivery and place of treatment. The data were analysed using the chi-square test for categorical data and the independent samples t-test for continuous data. Logistic regression analysis was used to calculate adjusted odds ratios for the variables of type of assisted delivery and place of treatment.
  
  
  METHODS
  Factors associated with increased risk of assisted delivery.
  
  
  RESULTS
  There was variation in rates of instrumental delivery between hospitals, with two having a significantly increased risk of assisted delivery, suggesting that place of treatment may be a factor in the risk of teenage patients experiencing an assisted delivery. There was also a large amount of variation in terms of the risk of experiencing a forceps or vacuum extraction compared to caesarean section. Age (under 16 years and 16-19 years of age) had no effect on the risk of a teenage patient experiencing an assisted delivery (X2 = 2.59 df = 1 P = 0.11 OR 1.27 (95% CI 0.94 to 1.72)). Similarly, teenagers who experience an assisted delivery were not more likely to come from a more deprived area than teenagers who did not have an assisted delivery (P = 0.189).
  
  
  CONCLUSIONS
  The risk of assisted delivery varied between hospitals, suggesting that this factor is important in terms of a young women's risk of an assisted delivery. The young women in this study who had experienced an assisted delivery were not significantly different to young women who had a normal delivery. They were not more likely to be aged under 16 years of age, and were not more likely to be from a more deprived area.
authors.affiliation: Division of Primary Care, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom. risepark@doctors.org.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Allen
authors.forename: Julia
authors.initials: J
authors.lastname: Hippisley-Cox
authors.forename: Mike
authors.initials: M
authors.lastname: Pringle
authors.forename: Lindsay
authors.initials: L
authors.lastname: Groom
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000145:classification / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D011204:Poverty Areas; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000706:statistics & numerical data*