142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Impact of Early Elective Deliveries in a State with the Highest Incidence of Infant Mortality

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 12:30 PM - 12:45 PM

Amy L. Radican-Wald, DrPH Candidate, MPH , Center for Mississippi Health Policy, Jackson, MS
Charlene Collier, MD, MPH , Health Services, Mississippi State Department of Health, Jackson, MS
Research Objective: To quantify recent trends in early elective deliveries including associated risk of infant death.

Study Design: Cohort of linked birth and death records to assess differences in mortality for babies born electively at 37 weeks gestation compared to 39 weeks gestation.

Population Studied: Singleton births and linked neonatal deaths from 2007 to 2011 for all babies born in Mississippi with non-medically indicated induction or caesarean section delivery.

Principal Findings: Early elective delivery rates doubled significantly (p<.01) from 2001-2011 from 8.5% to 16.5%, respectively. Babies delivered electively in Mississippi during 37 weeks of gestation had more than three times higher (OR 3.5, p<.05) neonatal death rates than babies delivered at 39 weeks gestation.

Conclusions: Early elective deliveries rose over the past decade in Mississippi and was associated with a three-fold higher risk of infant mortality. The practice of early elective deliveries resulted in increased harm to infants. These findings mirror previous studies which also show higher associated risks between the practice of early elective delivery and neonatal deaths.

Policy Implications: Limited published data were available concerning the impact of early elective delivery practice in Mississippi. Some states are showing improvements in newborn health outcomes associated with discouraging the practice of early elective deliveries through policy intervention. By altering the practice of early elective deliveries in a state with the highest infant mortality rates in the nation, improved birth outcomes could result. Further efforts are needed in Mississippi to reach the national standard target of 5 percent early elective deliveries.

Learning Areas:

Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Identify trends in early elective deliveries in a state with the highest incidence of infant mortality. Describe risk factors associated with the practice of early elective delivery. Assess the impacts early elective deliveries have on birth outcomes and infant mortality.

Keyword(s): Birth Outcomes, Infant Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist and senior policy analyst with over a decade of professional experience working with diverse stakeholders including government, non-profit and private organizations. I currently serve on the Board of Directors for the Mississippi Public Health Association and as Regional IV Affiliate Representative and Governing Council member for the American Public Health Association. I am a doctoral candidate completing a dissertation in public health epidemiology and hold a masters degree in public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.