regional variation in obstetrical intervention for hospital birth in the republic of ireland, 2005–2009地区差别在医院产科干预出生在爱尔兰共和国,2005 - 2009.pdfVIP

Regional variation in obstetrical intervention for hospital birth in the Republic of Ireland, 2005–2009 Lutomski et al. Lutomski et al. BMC Pregnancy and Childbirth 2012, 12:123 /1471-2393/12/123 Lutomski et al. BMC Pregnancy and Childbirth 2012, 12:123 /1471-2393/12/123 RESEARCH ARTICLE Open Access Regional variation in obstetrical intervention for hospital birth in the Republic of Ireland, 2005–2009 Jennifer E Lutomski1*, John J Morrison2 and Mona T Lydon-Rochelle1,3 Abstract Background: Obstetrical interventions during childbirth vary widely across European and North American countries. Regional differences in intrapartum care may reflect an inpatient-based, clinician-oriented, interventional practice style. Methods: Using nationally representative hospital discharge data, a retrospective cohort study was conducted to explore regional variation in obstetric intervention across four major regions (Dublin Mid Leinster; Dublin Northeast; South; West) within the Republic of Ireland. Specific focus was given to rates of induction of labour, caesarean delivery, epidural anaesthesia, blood transfusion, hysterectomy and episiotomy. Logistic regression analyses were performed to assess the association between geographical region and interventions while adjusting for patient case-mix. Results: 323,588 deliveries were examined. The incidence of interventions varied significantly across regions; the greatest disparities were observed for rates of induction of labour and caesarean delivery. Women in the South had nearly two-fold odds of having prostaglandins (adjusted OR: 1.75, 95% CI 1.68-1.82), whereas women in the West had 1.85 odds (95% CI 1.77-1.93) of artificial ruptur