Glantz J Christopher
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA.
J Matern Fetal Neonatal Med. 2011 Apr;24(4):636-42. doi: 10.3109/14767058.2010.514629. Epub 2010 Sep 14.
To determine whether variation in rates of labor induction (IOL) and primary cesarean delivery (PCD) among level I hospitals is associated with differences in neonatal outcomes.
A birth certificate database was used to calculate crude and adjusted rates of IOL and PCD among 10 regional hospitals. Adjustment via logistic regression controlled for differences in medical and demographic factors. Linear regression assessed the relationship of crude and adjusted IOL and PCD rates to rates of three neonatal outcomes.
IOL and PCD rates varied widely among hospitals (1.79- and 1.72-fold, respectively); variation increased following adjustment (1.93- and 1.86-fold, respectively). Rates of adverse neonatal outcomes varied by year and hospital, but not by IOL or PCD rates (p ≥ 0.05).
Crude and adjusted rates of labor induction and PCD vary among level I hospitals, but with no consistent effect on neonatal outcome.
确定一级医院中引产（IOL）率和初次剖宫产（PCD）率的差异是否与新生儿结局的差异相关。
使用出生证明数据库计算10家地区医院的IOL和PCD的粗率和调整率。通过逻辑回归进行调整，以控制医疗和人口因素的差异。线性回归评估IOL和PCD的粗率及调整率与三种新生儿结局发生率之间的关系。
各医院之间的IOL率和PCD率差异很大（分别为1.79倍和1.72倍）；调整后差异增大（分别为1.93倍和1.86倍）。不良新生儿结局的发生率因年份和医院而异，但与IOL或PCD率无关（p≥0.05）。
一级医院中引产和PCD的粗率及调整率各不相同，但对新生儿结局没有一致的影响。
