The average length of pregnancy in the US is shorter than in European countries

The average length of pregnancy in the US is shorter than in European countries

one. Gestational age distribution in 2020, All births, UK, Netherlands and USA Source: USA: CDC Wonder. UK: Office for National Statistics. Netherlands: b. Gestational age distribution* Home birth, UK, 2008–2010 & Netherlands & USA 2020. * For comparison with data from the UK, data are limited to births at 37 weeks and above; “0%” means less than 0.5%. Source: United States: CDC Wonder. UK: Birthplace Research. Netherlands: Credit: PLEASE ONE (2023). DOI: 10.1371/journal.pone.0278856

Maternal health outcomes continue to deteriorate in the United States, where maternal and infant mortality rates far outstrip rates in European countries and other wealthy nations. Now, a new study led by researchers at the Boston University School of Public Health (BUSPH) and the Harvard Medical School Beth Israel Deaconess Medical Center (BIDMC) is shedding new light on how Hospital organizational structure and staffing in maternal care in the United States can affect delivery. process and may contribute to adverse birth outcomes.

Posted in a magazine PLEASE ONEThe study analyzed the gestational age and timing of delivery at home and in the hospital in three high-income countries: the United States, where a model of maternity care mainly relies on obstetricians and clinical interventions, and England and the Netherlands, which rely heavily on midwives who provide low-intervention maternity care.

The findings show that the average duration of pregnancies in the United States has steadily decreased by more than half a week between 1990 and 2020, from 39.1 weeks to 38.5 weeks, and the average of pregnancies in The United States is shorter than the pregnancies in the UK and the Netherlands. In 2020, only 23% of births in the US occur at 40 weeks or more, compared with 44% of births in the Netherlands and 40% of births in the UK. The gestational age pattern for home births was similar in all three countries.

In all three countries, the researchers also examined the hour-of-day time of birth for home births and hospital vaginal births, then repeated the analysis, limiting comparisons with other cases. vaginal delivery in the hospital without interventions such as induction or assisted labor. time can be changed.

In the UK and the Netherlands, home and hospital births take place at similar times of the day, peaking in the early morning hours between 1am and 6am.

But in the US, there is a notable difference in the time of birth between the two settings: home births peak in the early morning like born at home in other countries. In contrast, hospital births – even those without intervention which can affect natural time patterns – largely occur during the standard working hours of clinical staff, from 8 a.m. morning to 5 pm.

The paper is the first international study to use large datasets to compare gestational age and time of birth in three high-income countries; Most previous studies have focused on data from individual hospitals or countries. With England and the Netherlands outstanding birth resultsThe authors say their findings suggest that US models of maternity care could benefit from an organizational shift with less emphasis on active, clinical and enabling labor management. childbirth occurs naturally.

“Our multinational analysis showed that the United States was an outlier in the gestational age distribution and low time of intervention. birth hospital“, said study lead and corresponding author, Dr. Eugene Declercq, professor of public health sciences at BUSPH. “There is a lesson to be learned from countries with more positive maternity outcomes. The United States in hospital staffing and operational planning is more in line with the standard of the natural model of time of birth and gestational age rather than trying to match the time of birth with the needs of the organization. ”

The study included nationally representative and publicly available population-based birth data from all three countries, including data on more than 3.8 million births in the United States and 156,000 births in the Netherlands in 2014 and more than 56,000 births in the UK between 2008-2010. The researchers examined the home and hospital Giving birth time for births that occur between 37 and 42 weeks.

Dr Neel Shah, medical director of the Maven Clinic and visiting scientist at BIDMC, said: “Every system is perfectly designed to achieve the desired results. “The alarmingly poor outcomes of the US maternal health care system require more attention to its design. Our study shows that compared with other systems. high income countriesHospitals in the US could be designed to focus on the clinician’s convenience rather than the needs of the population. Giving birth.”

More information:
Eugene Declercq et al, Natural patterns of time of birth and gestational age in the United States versus Great Britain and the Netherlands, PLEASE ONE (2023). DOI: 10.1371/journal.pone.0278856

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Boston University

quote: Mean pregnancy duration in the US is shorter than in European countries (2023, january 21) obtained January 21, 2023 from pregnancy-length-shorter-european.html

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