American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 404.e1-404.e4, October 2009

Late preterm birth: how often is it avoidable?

Presented in part at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 26-31, 2009.

  • Marium G. Holland, MD, MPH

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX
    • ,
  • Jerrie S. Refuerzo, MD

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX
    • ,
  • Susan M. Ramin, MD

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX
    • ,
  • George R. Saade, MD

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX
    • ,
  • Sean C. Blackwell, MD

      Affiliations

    • Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX

Received 27 February 2009; received in revised form 31 May 2009; accepted 30 June 2009. published online 31 August 2009.

Objective

Our objective was to describe indications for late preterm birth (LPTB) and estimate the frequency of potentially avoidable LPTB deliveries.

Study Design

Singleton pregnancies delivered between 340/7–366/7 weeks over a 1-year period at a tertiary care medical center were studied. Indications for delivery were categorized as spontaneous (spontaneous preterm birth or premature rupture of membranes) or iatrogenic (elective or medically indicated). Potentially avoidable deliveries were defined as those with elective or medical stable, but high-risk indications.

Results

During the study period there were 514 LPTB (spontaneous preterm birth 36.2%, preterm premature rupture of membranes 17.7%, medically indicated 37.9%, and elective 8.2%). Potentially avoidable LPTB accounted for 17% of LPTB and were associated with later gestational age (odds ratio [OR], 4.7; 95% confidence interval [CI], 2.5–8.6), nonfaculty physician status (OR, 2.8; 95% CI, 1.5–5.1), and prior cesarean delivery (OR, 1.5; 95% CI, 1.0–2.1).

Conclusion

At our institution, <10% of LPTB are purely elective and >80% are clearly unavoidable.

Key words: elective delivery, late preterm birth, practice patterns, prematurity, preterm birth

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 Reprints not available from the authors.

 Cite this article as: Holland MG, Refuerzo JS, Ramin SM, et al. Late preterm birth: how often is it avoidable? Am J Obstet Gynecol 2009;201:404.e1-4.

PII: S0002-9378(09)00761-3

doi:10.1016/j.ajog.2009.06.066

American Journal of Obstetrics & Gynecology
Volume 201, Issue 4 , Pages 404.e1-404.e4, October 2009

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