Higher Cesarean Risk Tied to Low Delivery Volume by Doctors
(HealthDay News) — The odds of cesarean delivery are increased for patients who undergo delivery by obstetricians with low delivery volume, according to a study published online September 8 in Obstetrics & Gynecology.
Mark A. Clapp, MD, MPH, from Brigham and Women's Hospital in Boston, and colleagues conducted a retrospective cohort study to examine the correlation between an obstetrician's delivery volume and a patient's risk for cesarean delivery. Patient-level and obstetrician-level data were obtained for all 58,328 laboring patients who delivered viable, live-born, singleton newborns at Brigham and Women's between 2000–2012.
The researchers found that 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 vs. quartile 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," the authors write.