After rates increased steadily for nearly two decades, a new Centers for Disease Control and Prevention report notes a decline in induction of labor for single births.
Although the declines are very modest, going from 23.7% in 2011 to 23.3% in 2012, the news is encouraging, according to a CDC news release. Although delivery is medically necessary in some instances, delivery for a non-medical reason is not recommended before 39 weeks gestation. Risks of labor induction can include increased risk of cesarean section and, in some cases, increased risk for neonatal infections and neonatal respiratory complications.
According to the CDCs National Center for Health Statistics report Recent Declines in Induction of Labor by Gestational Age, released June 18, trends in induction rates vary by gestational age, with rates for most gestational age groups declining since 2010. Induction rates for births at 36, 37 and 38 weeks have declined since 2006, with the largest decrease at 38 weeks.
From 1981 through 2006, the proportion of infants born at less than 39 completed weeks of gestation increased nearly 60%, while births at 39 weeks or more declined more than 20%, which has been associated with greater use of cesarean delivery and induction of labor prior to full term, according to a CDC data brief. However, since 2006, births delivered at less than 39 weeks have declined by 12% and births at 39 weeks or more have increased by 9%. From 2006 through 2012, induction rates at 38 weeks of gestation declined for all maternal age groups under 40.
Induction rates were at least twice as high in 2010 as in 1990 for all gestational age groups except postterm births, which rose 90%.
Trends in induction rates at each week 35-38 varied by maternal age from 2006 through 2012. At 38 weeks, induction rates declined for all maternal age groups under 40, dropping 13%-19% for women in their 20s and 30s. Patterns varied for the youngest and oldest moms. Whereas induction rates at 38 weeks declined for women under 20 from 2006 through 2012, rates at 35, 36, and 37 weeks increased 5%-10% for this age group. Induction rates for women aged 40 and over were essentially unchanged for all weeks 35-38 during this time.
From 2006 through 2012, induction rates at 38 weeks declined in nearly three-quarters of all states. For 36 states and the District of Columbia, induction rates at 38 weeks were lower in 2012 than in 2006. Declines ranged from 5% in Maryland to 48% in Utah. Rates declined at least 10% in 31 states and D.C., and rates in five states dropped at least 30% during this time. Rates at 38 weeks increased for Alaska (33%), New York (11%) and North Carolina (9%) from 2006 through 2012, while rates for the remaining states were unchanged.
This report is based on data from the National Vital Statistics System.
For the full report, go to http://www.cdc.gov/nchs/data/databriefs/db155.htm