Glantz J Christopher
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA.
Birth. 2003 Sep;30(3):168-74. doi: 10.1046/j.1523-536x.2003.00241.x.
Labor induction rates in the United States rose from 9.0 percent in 1989 to 20.5 percent in 2001, but reasons for the increase are poorly defined. A birth database from a region of upstate New York, including 31,352 deliveries from 1998 through 1999, was used to determine the degree of variation of labor induction rates among hospitals and practitioners.
Total and elective labor induction rates were calculated for 16 hospitals and individual staff, and then evaluated using chi-square testing and regression.
Using all laboring women as the denominator, the regional labor induction rate was 20.8 percent; of these inductions, 25 percent had no apparent medical indication. Total induction rates and percent of elective inductions that were elective varied significantly among hospitals (10%-39% and 12%-55%, respectively, p<0.0001) and among practitioners within hospitals (7%-48% and 3%-76%, respectively, p<0.0001). Hospitals varied in size, risk status, and cesarean section rates, but these factors did not correlate with induction rates.
Labor induction rates are highly variable among and within hospitals. Delivery volume, population risk status, and differences in cesarean section rates did not explain this variation.
美国的引产率从1989年的9.0%上升至2001年的20.5%，但上升原因尚不明确。利用纽约州北部某地区的一个出生数据库（包括1998年至1999年的31352例分娩）来确定医院和从业者之间引产率的差异程度。
计算16家医院及个体工作人员的总引产率和择期引产率，然后采用卡方检验和回归分析进行评估。
以所有分娩女性作为分母，该地区的引产率为20.8%；在这些引产中，25%没有明显的医学指征。总引产率以及择期引产中属于择期的比例在不同医院之间（分别为10% - 39%和12% - 55%，p<0.0001）以及医院内不同从业者之间（分别为7% - 48%和3% - 76%，p<0.0001）差异显著。医院在规模、风险状况和剖宫产率方面存在差异，但这些因素与引产率无关。
引产率在医院之间以及医院内部差异很大。分娩量、人群风险状况和剖宫产率的差异并不能解释这种差异。
