title: Maternal and neonatal complications of elective early-term deliveries.
abstract: Approximately 10% to 15% of all deliveries in the United States are performed before 39 completed weeks of gestation without a true medical indication for early delivery, despite long-standing recommendations against this practice. Early-term deliveries are those that occur between 3707 and 3867 weeks. It is now recognized that maternal and neonatal complications have increased for deliveries that occur at early- vs late-term gestation. The reasons for the increase in the rate of elective early-term deliveries are unclear but likely involve both patient and physician factors. Various strategies have been used to increase awareness of the morbidities associated with the practice of elective early-term delivery and to reduce its frequency. Insurers and quality accrediting agencies are increasingly holding hospitals accountable for their rates of elective early-term deliveries, and this pressure will likely continue to lead to widespread change in the practice of obstetrics. The interventions to increase adherence to evidence-based medicine guidelines that are described within this review may also be applicable to other areas of medicine.
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN. Electronic address: Jensen.jani@mayo.edu.
authors.forename: Jani R
authors.initials: JR
authors.lastname: Jensen
authors.forename: Wendy M
authors.initials: WM
authors.lastname: White
authors.forename: Charles C
authors.initials: CC
authors.lastname: Coddington
mesh_terms: D036861:Delivery, Obstetric / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D014481:United States
keywords: ACOG; American Congress of Obstetricians and Gynecologists; FLM; NICU; OR; PPH; RR; fetal lung maturity; neonatal intensive care unit; odds ratio; postpartum hemorrhage; relative risk