Unnecessary Early Deliveries of Babies Reduced Considerably, Study Finds
Posted on Apr 8, 2013 in Quality
Sutter Health Network Sees Even Greater Decreases
A study published today in Obstetrics & Gynecology shows that multistate, hospital-based quality improvement programs, including the one piloted for March of Dimes at Sutter Health-affiliated hospitals Mills-Peninsula Health Services in Burlingame, Sutter Medical Center, Sacramento and Sutter Roseville Medical Center, can be remarkably effective at reducing early elective deliveries of babies.
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The rate of elective early term deliveries (i.e., inductions of labor and Cesarean sections without a medical reason), in a group of 25 participating hospitals nationwide, fell significantly from 27.8 percent to 4.8 percent during the one-year study period, an 83 percent decline.
In 2010, Sutter Health implemented a similar program across its Northern California network to reduce the delivery of babies before 39 weeks of pregnancy. Since beginning its program, Sutter has seen a nearly 90 percent drop in early elective deliveries.
The March of Dimes, which partly funded the study, says the reduction of early elective deliveries is good news for moms and babies because newborns delivered before full-term are at increased risk of serious health problems and death in their first year of life.
“This quality improvement program demonstrates that we can create a change in medical culture to prevent unneeded early deliveries and give many more babies a healthy start in life,” says Bryan T. Oshiro, MD, of Loma Linda University School of Medicine and lead author of the study.
In Sacramento, both Sutter hospitals saw similar decreases, with Sutter Roseville seeing a decline from 29 percent in 2010 to just 4 percent in 2012, and Sutter Medical Center, Sacramento having a rate of 15 percent in 2010 to 2.3 percent in 2012.
“Across our entire Northern California network, we’ve partnered with expectant moms to hold off on elective deliveries before 39 weeks of pregnancy, because it is the best thing we can do for our mothers and babies,” said William Gilbert, M.D., medical director of Sutter Women’s Services for Sutter Health Sacramento Sierra Region. “Our work means even more babies are born healthier and go home sooner.”
To achieve these results, Sutter Health implemented a toolkit called “Elimination of Non-medically Indicated (Elective) Deliveries before 39 Weeks Gestational Age” to guide changes in early term delivery practices. The toolkit was developed in partnership with the March of Dimes, the California Maternal Quality Care Collaborative and the California Maternal Child and Adolescent Division within the California Department of Public Health. It can be downloaded free from the Prematurity Prevention Resource Center at prematurityprevention.org.
Sutter Medical Center, Sacramento and Sutter Roseville Medical Center were two of the first hospitals in the nation to participate in a collaborative of perinatal quality improvement advocates with state health departments, academic health centers, and March of Dimes chapters from the five most populous states in the country: California, Texas, New York, Florida and Illinois. These five states account for an estimated 38 percent of all births in the United States.
The March of Dimes urges hospitals, health care providers, and patients to follow American College of Obstetricians and Gynecologists guidelines that if a pregnancy is healthy, to wait for labor to begin on its own. The final weeks of pregnancy are crucial to a baby’s health because many vital organs, including the brain and lungs, are still developing.