Average pregnancy length in the US is shorter than in European countries

a. 2020 gestational age distribution, all births, UK, Netherlands, and US Source: US: CDC Wonder. England: Office for National Statistics. Netherlands: Peristat.nl. b. Gestational Age Distribution* Homebirth, UK, 2008-2010, Netherlands and US, 2020. “0%” means less than 0.5%. Source: USA: CDC Wonder. UK: Origin Studies. Netherlands: Peristat.nl. Credits: pro swan (2023). DOI: 10.1371/journal.pone.0278856

Maternal health continues to deteriorate in the United States, with maternal and infant mortality rates far exceeding those of European and other wealthy countries. Now, a new study led by researchers at the Boston University School of Public Health (BUSPH) and Harvard Medical School’s Beth Israel Deaconess Medical Center (BIDMC) shows how hospital organizational structure and staffing affect childbirth in U.S. obstetric care. gains insight into how Through the process, it can adversely affect the outcome of childbirth.

It was published in the magazine pro swanThis study examined gestational patterns and home outcomes in three high-income countries, the United States, which employs an obstetric care model that relies heavily on obstetricians and clinical interventions, and the United Kingdom and the Netherlands, which rely primarily on midwives. and the timing of delivery in hospital. A person who provides low-intervention obstetric care.

Findings show that the average U.S. gestational age steadily declined by more than half a week from 39.1 weeks to 38.5 weeks between 1990 and 2020, with U.S. gestational age on average surpassing British and Dutch pregnancies shorter than the period. In 2020, only 23% of births were over 40 weeks in the US, compared to 44% in the Netherlands and 40% in the UK. The gestational age pattern for home births was similar in all three countries.

The researchers also investigated the timing of deliveries by hour of the day for home and hospital vaginal deliveries in all three countries, and repeated this analysis to determine hospital interventions such as induction and labor augmentation. limited comparisons with vaginal delivery at . Timing may change.

In England and the Netherlands, home and hospital births occurred at roughly the same time of day, peaking in the early morning between 1am and 6am.

However, in the United States, there was a notable difference in birth timing between the two settings. Home births peaked in the early morning hours, the same as home births in other countries. In contrast, hospital births predominantly occur during the standard working hours of clinical staff, 8:00 a.m. to 5:00 p.m., even in the absence of interventions that may affect natural timing patterns. Did.

This paper is the first international study to compare gestational age and birth timing in three high-income countries using a large dataset. Most previous studies focused on data from individual hospitals or countries. Given the excellent birth outcomes in the UK and the Netherlands, the authors concluded that their findings suggest that organizations that place less emphasis on active, clinical birth control and allow the birth process to take its natural course. suggest that they may benefit from the migration of

“Our multi-country analysis shows that the United States is an outlier in terms of gestational age distribution and timing of low-intervention hospital births,” said lead and lead author of the study and professor of community health sciences at BUSPH. said Eugene Declercq, Ph.D. “Rather than trying to match the timing of births to organizational needs, hospital staffing and operational planning more closely resembles the natural patterns of birth timing and gestational age, resulting in more positive birth outcomes than in the United States. There are lessons to be learned from the countries where we live.”

The study included data on over 3.8 million births in the United States in 2014, 156,000 births in the Netherlands, and over 56,000 births in the United Kingdom from 2008 to 2010. It included nationally representative, publicly available population-based birth data from all three countries. The researchers looked at the timing of home and hospital deliveries for deliveries that occurred between 37 weeks and her 42 weeks.

“Every system is designed from the ground up to give you the results you want,” said Neel Shah, Ph.D., chief medical officer at the Maven Clinic and visiting scientist at BIDMC, senior author of the study. said. “The shockingly poor results of the U.S. maternal health system require more attention to its design. This indicates that it may have been designed with a focus on clinician convenience rather than .”

For more information:
Eugene Declercq et al. Natural patterns of birth timing and gestational age in the United States compared to the United Kingdom and the Netherlands. pro swan (2023). DOI: 10.1371/journal.pone.0278856

Courtesy of Boston University

Quote: Average gestational age in the US is shorter than in European countries (21 Jan 2023) from https://medicalxpress.com/news/2023-01-average-pregnancy-length-shorter-european.html to Jan 2023 Retrieved on the 21st

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