Late preterm birth: how often is it avoidable?
OBJECTIVE
Our objective was to describe indications for late preterm birth (LPTB) and estimate the frequency of potentially avoidable LPTB deliveries.


METHODS
Singleton pregnancies delivered between 34(0/7)-36(6/7) weeks over a 1-year period at a tertiary care medical center were studied. Indications for delivery were categorized as spontaneous (spontaneous preterm birth or premature rupture of membranes) or iatrogenic (elective or medically indicated). Potentially avoidable deliveries were defined as those with elective or medical stable, but high-risk indications.


RESULTS
During the study period there were 514 LPTB (spontaneous preterm birth 36.2%, preterm premature rupture of membranes 17.7%, medically indicated 37.9%, and elective 8.2%). Potentially avoidable LPTB accounted for 17% of LPTB and were associated with later gestational age (odds ratio [OR], 4.7; 95% confidence interval [CI], 2.5-8.6), nonfaculty physician status (OR, 2.8; 95% CI, 1.5-5.1), and prior cesarean delivery (OR, 1.5; 95% CI, 1.0-2.1).


CONCLUSIONS
At our institution, <10% of LPTB are purely elective and >80% are clearly unavoidable.
Holland
Marium G
MG
Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School, Houston, TX, USA.
Refuerzo
Jerrie S
JS
Ramin
Susan M
SM
Saade
George R
GR
Blackwell
Sean C
SC
D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D010818:Practice Patterns, Physicians'; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D047928:Premature Birth / Q000453:epidemiology / Q000517:prevention & control*