Centenary Hospital for Women and Children, ACT and University of Canberra, Kirinari St., Bruce, ACT 2617, Australia.
ACT Government Health Directorate and University of Canberra, Kirinari St., Bruce, ACT 2617, Australia.
Women Birth. 2022 Mar;35(2):e181-e187. doi: 10.1016/j.wombi.2021.05.004. Epub 2021 May 24.
In many well-resourced countries, rising rates of intervention are being observed during pregnancy, labour and childbirth with induction of labour (IOL) fast becoming one of the most common. In Australia, the rate of induction of labour has increased by over 30% since 2007, and today one in three women have their labours induced. We do not however have a good understanding of the contribution of specific obstetric populations to this trend.
We examine the contribution of specific obstetric populations to induction of labour over a six-year period at one tertiary maternity service, using the Nippita classification system. Average Annual Percentage Changes (AAPC) were calculated along with 95% confidence intervals and P values set at 0.05.
The overall rate of induction of labour increased from 21.3% in 2012 to 30.9% in 2017, representing an Average Annual Percent Change of 8.1, P<0.0001 (95% CI 7-9.6). The greatest AAPC was seen in group 5 (parous, no previous caesarean section, 39-40 weeks, single cephalic), followed by group 2 (nulliparous, 39-40 weeks, single cephalic) and 1 (nulliparous, 37-38 weeks, single cephalic).
The use of the Nippita classification system allowed for standardised comparison across timepoints, facilitating identification of the subpopulations driving changes in rates of induction of labour. Rates of induction of labour saw a year on year increase which in this maternity service, it is not being driven by post-dates pregnancies. Further work is required to understand the role of other potential contributors such as diabetes.
在许多资源丰富的国家，妊娠、分娩和分娩期间的干预率不断上升，引产（IOL）迅速成为最常见的干预方式之一。在澳大利亚，自 2007 年以来，引产率增加了 30%以上，如今每三个产妇中就有一个产妇引产。然而，我们并不清楚特定产科人群对这一趋势的贡献。
我们使用 Nippita 分类系统，在一家三级产科服务机构，在六年期间检查特定产科人群对引产的贡献。计算了平均年百分比变化（AAPC），并计算了 95%置信区间和 P 值，设定为 0.05。
总的引产率从 2012 年的 21.3%增加到 2017 年的 30.9%，平均年百分比变化为 8.1，P<0.0001（95%CI 7-9.6）。最大的 AAPC 见于第 5 组（经产妇，无剖宫产史，39-40 周，单胎头位），其次是第 2 组（初产妇，39-40 周，单胎头位）和第 1 组（初产妇，37-38 周，单胎头位）。
使用 Nippita 分类系统可以在不同时间点进行标准化比较，有助于确定驱动引产率变化的亚人群。引产率逐年上升，但在本产科服务机构中，并非由过期妊娠引起。需要进一步研究了解其他潜在因素（如糖尿病）的作用。
