title: Trends in planned early birth: a population-based study.
abstract: OBJECTIVE
  The purpose of this study was to describe trends and outcomes of planned births.
  
  
  METHODS
  Data from linked birth and hospital records for 779,521 singleton births at ≥33 weeks' gestation from 2001-2009 were used to determine trends in planned births (prelabor cesarean section and labor inductions). Adverse outcomes were composite indicators of maternal and neonatal morbidity/death.
  
  
  RESULTS
  From 2001-2009, there were increases in labor inductions and prelabor cesarean deliveries at <40 weeks' gestation, but no decrease in the stillbirth rate (trend P = .34). By 2009, 14.9% of live births at ≥33 weeks' gestation were prelabor cesarean deliveries before the due date; 11.4% were inductions. As planned births increased, maternal risks shifted, which included a decline in inductions with maternal hypertension from 31.9-23.9%. Earlier birth was contemporaneous with increases (trend P < .001) in neonatal and maternal morbidity rates from 3.0-3.2% and 1.1-1.5%, respectively.
  
  
  CONCLUSIONS
  Planned birth before the due date is increasing without a contemporaneous reduction of stillbirths.
authors.affiliation: Department of Obstetrics, Gynaecology, and Neonatology, University of Sydney at Royal North Shore Hospital, St Leonards, Sydney, Australia.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Morris
authors.forename: Charles S
authors.initials: CS
authors.lastname: Algert
authors.forename: Michael O
authors.initials: MO
authors.lastname: Falster
authors.forename: Jane B
authors.initials: JB
authors.lastname: Ford
authors.forename: Ann
authors.initials: A
authors.lastname: Kinnear
authors.forename: Michael C
authors.initials: MC
authors.lastname: Nicholl
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000639:trends*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000639:trends*; D011247:Pregnancy; D011256:Pregnancy Outcome