Elsevier

Seminars in Perinatology

Volume 26, Issue 4, August 2002, Pages 250-259
Seminars in Perinatology

Obstetric intervention, stillbirth, and preterm birth

https://doi.org/10.1053/sper.2002.34769Get rights and content

Despite widespread recognition that preventing preterm birth is the most important perinatal challenge facing industrialized countries, preterm birth has increased steadily in recent years. This article examines the relation between trends in preterm birth, preterm labor induction/cesarean delivery, stillbirth, and infant mortality. The recent rise in preterm birth in the United States and Canada has been mainly due to increases in mild preterm birth (34–36 weeks). Live births at 34 to 36 week's gestation have increased largely as a consequence of increases in preterm induction and preterm cesarean delivery among women at high risk for adverse pregnancy outcomes. Increased obstetric intervention at 34 to 36 weeks' gestation appears to have led to larger-than-expected temporal declines in stillbirth rates at this gestation. Infant mortality rates have declined overall and also among live births at 34 to 36 week's gestation. Obstetric intervention at preterm gestation, when indicated, can prevent stillbirth and reduce infant morbidity and mortality despite the increasing rates of preterm delivery.

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    1

    K.S.J. is supported by a Clinical Scholar award from the Dalhousie University Faculty of Medicine

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    M.S.K. is a Distinguished Scientist of the Canadian Institutes of Health Research

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