Comparing Data Helps Hospitals Reduce Medically Unnecessary Early Deliveries, Study Finds

August 6, 2012 — A quality improvement initiative at Ohio hospitals helped reduce the number of medically unnecessary early deliveries from 7% of all births to 3% from October 2008 to December 2009, according to a study in the journal Obstetrics & Gynecology, Reuters reports.

The researchers assessed an initiative developed by the Ohio Perinatal Quality Collaborative to reduce the number of deliveries scheduled before women's due dates for reasons other than medical necessity. Experts hope reducing medically unnecessary scheduled births will help prevent problems in infants, such as breathing and temperature regulation issues, that can result from being born too soon.

The initiative involved 20 hospitals that contributed early delivery information to a common database so they could compare performance. Each facility set its own strategy for how to reduce unnecessary early deliveries, such as requiring approval from a second nurse or doctor.

The researchers classified the births as medically necessary, such as if there were multiple fetuses or the placenta detached, or medically unnecessary, including when the woman had herpes, Crohn's disease or was older. In the last four months of the study, there were 145 fewer unnecessary early deliveries scheduled than in the first four months.

Many of the early births were for valid medical reasons, the study found. However, the proportion of births that required an early delivery did not change, which indicated that doctors were not simply recording births differently later in the study so they could deliver earlier, according to lead author Jennifer Bailit, an associate professor at the Case Western Reserve University School of Medicine (Grens, Reuters, 8/2).