Cesarean risk higher with low-delivery-volume obstetricians

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The odds of cesarean delivery were two-fold higher for patients whose obstetricians performed fewer than 60 deliveries per year.

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Cesarean risk higher with low-delivery-volume obstetricians
Cesarean risk higher with low-delivery-volume obstetricians

HealthDay News -- The odds of cesarean delivery are increased for patients who undergo delivery by obstetricians with low delivery volume, according to researchers.

To examine the correlation between an obstetrician's delivery volume and a patient's risk for cesarean delivery, Mark A. Clapp, MD, MPH, from Brigham and Women's Hospital in Boston, and colleagues conducted a retrospective cohort study.

Patient- and obstetrician-level data were obtained for 58,328 laboring patients who delivered viable, live-born, singleton newborns at Brigham and Women's between 2000 and 2012. The researchers' findings were published in Obstetrics & Gynecology.

The odds of cesarean delivery were increased two-fold for patients whose obstetricians performed fewer than the median of 60 deliveries per year (quartiles 1 and 2 versus quartile 3 and 4: odds ratios, 2 and 2.73). From the lowest- to the highest-volume quartile, the adjusted cesarean delivery rate decreased from 18.2% to 9.2%. An obstetrician's experience had a smaller effect than volume on a patient's risk of cesarean delivery.

"These findings may prompt discussions regarding the role of volume in credentialing and practice models that direct patients to obstetricians with high delivery volume," concluded the researchers.

References

  1. Clapp M et al. Obstetrics & Gynecology. 2014; doi: 10.1097/AOG.0000000000000473


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