title: Rates of labor induction and primary cesarean delivery do not correlate with rates of adverse neonatal outcome in level I hospitals.
abstract: OBJECTIVE
  To determine whether variation in rates of labor induction (IOL) and primary cesarean delivery (PCD) among level I hospitals is associated with differences in neonatal outcomes.
  
  
  METHODS
  A birth certificate database was used to calculate crude and adjusted rates of IOL and PCD among 10 regional hospitals. Adjustment via logistic regression controlled for differences in medical and demographic factors. Linear regression assessed the relationship of crude and adjusted IOL and PCD rates to rates of three neonatal outcomes.
  
  
  RESULTS
  IOL and PCD rates varied widely among hospitals (1.79- and 1.72-fold, respectively); variation increased following adjustment (1.93- and 1.86-fold, respectively). Rates of adverse neonatal outcomes varied by year and hospital, but not by IOL or PCD rates (p ≥ 0.05).
  
  
  CONCLUSIONS
  Crude and adjusted rates of labor induction and PCD vary among level I hospitals, but with no consistent effect on neonatal outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA. chris_glantz@urmc.rochester.edu
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Glantz
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D016208:Databases, Factual / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult