• J Christopher Glantz.
• Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA. chris_glantz@urmc.rochester.edu
• J. Matern. Fetal. Neonatal. Med. 2011 Apr 1; 24 (4): 636-42.

ObjectiveTo determine whether variation in rates of labor induction (IOL) and primary cesarean delivery (PCD) among level I hospitals is associated with differences in neonatal outcomes.MethodsA birth certificate database was used to calculate crude and adjusted rates of IOL and PCD among 10 regional hospitals. Adjustment via logistic regression controlled for differences in medical and demographic factors. Linear regression assessed the relationship of crude and adjusted IOL and PCD rates to rates of three neonatal outcomes.ResultsIOL and PCD rates varied widely among hospitals (1.79- and 1.72-fold, respectively); variation increased following adjustment (1.93- and 1.86-fold, respectively). Rates of adverse neonatal outcomes varied by year and hospital, but not by IOL or PCD rates (p ≥ 0.05).ConclusionsCrude and adjusted rates of labor induction and PCD vary among level I hospitals, but with no consistent effect on neonatal outcome.

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