Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-4993
Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study
Authors: Seijmonsbergen-Schermers, Anna
de Jonge, Ank
van den Akker, Thomas
Beeckman, Katrien
Bogaerts, Annick
Barros, Monalisa
Janssen, Patricia
Binfa, Lorena
Rydahl, Eva
Frith, Lucy
Gross, Mechthild Maria
Hálfdánsdóttir, Berglind
Daly, Deirdre
Calleja-Agius, Jean
Gillen, Patricia
Vika Nilsen, Anne Britt
Declercq, Eugene
DOI: 10.21256/zhaw-4993
10.1136/bmjopen-2017-017993
Published in: BMJ Open
Volume(Issue): 8
Issue: 1
Issue Date: 2018
Publisher / Ed. Institution: BMJ Publishing Group
ISSN: 2044-6055
Language: English
Subjects: Caesarean section; Childbirth interventions; Episiotomy; Instrumental delivery; International variations; Maternal and perinatal outcmes; Adult; Anesthesia, Epidural; Anti-Bacterial Agents; Cesarean Section; Cross-Cultural Comparison; Cross-Sectional Studies; Delivery, Obstetric; Episiotomy; Female; Humans; Infant, Newborn; Labor, Induced; Oxytocin; Postpartum Period; Pregnancy; Research Design; Surgical Instruments; Vacuum Extraction, Obstetrical; Developed Countries
Subject (DDC): 618.4: Childbirth
Abstract: Introduction: There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. Methods and analysis: This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country.
URI: https://digitalcollection.zhaw.ch/handle/11475/14626
Fulltext version: Published version
License (according to publishing contract): CC BY-NC 4.0: Attribution - Non commercial 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Midwifery and Reproductive Health (IHG)
Appears in collections:Publikationen Gesundheit

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Seijmonsbergen-Schermers, A., de Jonge, A., van den Akker, T., Beeckman, K., Bogaerts, A., Barros, M., Janssen, P., Binfa, L., Rydahl, E., Frith, L., Gross, M. M., Hálfdánsdóttir, B., Daly, D., Calleja-Agius, J., Gillen, P., Vika Nilsen, A. B., & Declercq, E. (2018). Variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study. BMJ Open, 8(1). https://doi.org/10.21256/zhaw-4993
Seijmonsbergen-Schermers, A. et al. (2018) ‘Variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study’, BMJ Open, 8(1). Available at: https://doi.org/10.21256/zhaw-4993.
A. Seijmonsbergen-Schermers et al., “Variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study,” BMJ Open, vol. 8, no. 1, 2018, doi: 10.21256/zhaw-4993.
SEIJMONSBERGEN-SCHERMERS, Anna, Ank DE JONGE, Thomas VAN DEN AKKER, Katrien BEECKMAN, Annick BOGAERTS, Monalisa BARROS, Patricia JANSSEN, Lorena BINFA, Eva RYDAHL, Lucy FRITH, Mechthild Maria GROSS, Berglind HÁLFDÁNSDÓTTIR, Deirdre DALY, Jean CALLEJA-AGIUS, Patricia GILLEN, Anne Britt VIKA NILSEN und Eugene DECLERCQ, 2018. Variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study. BMJ Open. 2018. Bd. 8, Nr. 1. DOI 10.21256/zhaw-4993
Seijmonsbergen-Schermers, Anna, Ank de Jonge, Thomas van den Akker, Katrien Beeckman, Annick Bogaerts, Monalisa Barros, Patricia Janssen, et al. 2018. “Variations in Childbirth Interventions in High-Income Countries : Protocol for a Multinational Cross-Sectional Study.” BMJ Open 8 (1). https://doi.org/10.21256/zhaw-4993.
Seijmonsbergen-Schermers, Anna, et al. “Variations in Childbirth Interventions in High-Income Countries : Protocol for a Multinational Cross-Sectional Study.” BMJ Open, vol. 8, no. 1, 2018, https://doi.org/10.21256/zhaw-4993.


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