Outcomes Assessed for Oregon's 'Hard-Stop' on Non-Medically Necessary Inductions

Reduction in rate of elective inductions before 39 weeks, and in elective early-term cesareans
Reduction in rate of elective inductions before 39 weeks, and in elective early-term cesareans

HealthDay News — Introduction of the hard-stop policy in Oregon was associated with a reduction in elective early-term deliveries, according to a study published in the December issue of Obstetrics & Gynecology.

Jonathan M. Snowden, PhD, from the Oregon Health & Science University in Portland, and colleagues conducted a population-based retrospective cohort study of Oregon births from 2008 to 2013. They examined the outcomes of induction of labor and cesarean section at 37 or 38 weeks of gestation without a documented indication on the birth certificate before and after the Oregon hard-stop policy (2008 to 2010 and 2012 to 2013, respectively). 

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The researchers observed a decrease in the rate of elective inductions before 39 weeks of gestation, from 4.0% in the pre-policy period to 2.5% during the post-policy period (P<0.001); elective early-term cesarean deliveries also decreased (from 3.4 to 2.1%; P<0.001). From pre- to post-policy, there was no change observed in neonatal intensive care unit admission, stillbirth, or assisted ventilation; chorioamnionitis increased from 1.2 to 2.2% (adjusted odds ratio, 1.94; P<0.001).

"Oregon's statewide policy to limit elective early-term delivery was associated with a reduction in elective early-term deliveries, but no improvement in maternal or neonatal outcomes," the authors write.

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