PloS one · 2026
Temporal-spatial trends in childbirth in Ontario, Canada.
СтатьяНазвание и аннотация: Перевод в очереди
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Habbous Steven, Snelgrove John W, Smith Michaela A, Miao Grace, Dingwall-Harvey Alysha, Petersen Stephen, Lambrinos Anna, Nguyen David, Shah Prakesh S, Hellsten Erik
Аннотация
INTRODUCTION: The importance of understanding the continuum of care throughout the perinatal/postpartum periods is important for health system monitoring and quality improvement. In this study, we take a broad-ranging and longitudinal perspective to examining long-term changes in obstetric care.
METHODS: This is a retrospective population-based study including all liveborn deliveries from 2010-2023 in Ontario, Canada. We used the hospital Discharge Abstract Database to link delivery and newborn abstracts. We report year-over-year changes in socio-demographics, clinical factors, care patterns, and perinatal and postpartum outcomes.
RESULTS: The number of in-hospital births decreased from 133,957 in 2010-127,660 in 2023. Over the study period, delivery age increased from a mean 30.6 years (SD 5.5) in 2010 to 32.2 (SD 4.9) in 2023 and there was at least a doubling in the proportion of persons who delivered having preexisting/gestational diabetes (5.6% in 2010, 11.1% in 2023), obesity (1.6% in 2010, 4.6% in 2023), pre-eclampsia/eclampsia (1.1% in 2010, 2.6% in 2023), liver disorders (0.43% in 2010; 1.16% in 2023), and other diseases (4.9% in 2010, 10.7% in 2023), p < 0.0001 for all. The proportion of deliveries performed via C-section increased over time (29.3% in 2010, 34.6% in 2023) but the median length-of-stay decreased 2.68% year-over-year. Use of epidural increased non-linearly over the study period and was less likely at lower-volume hospitals. Although uncommon (<5%), the rate of obstetric trauma and birth trauma increased over the study period, regardless of the mode of delivery (p < 0.0001). Six-month mortality did not change over the study period after delivery, while infant mortality decreased (0.35% in 2010 to 0.26% in 2023). We also observed substantial hospital-level variation in utility of services including midwifery care and access to epidural.
CONCLUSION: Over the last 14 years, we found an increasing incidence of people giving birth at an older age and having complicating clinical characteristics at the time of delivery.
METHODS: This is a retrospective population-based study including all liveborn deliveries from 2010-2023 in Ontario, Canada. We used the hospital Discharge Abstract Database to link delivery and newborn abstracts. We report year-over-year changes in socio-demographics, clinical factors, care patterns, and perinatal and postpartum outcomes.
RESULTS: The number of in-hospital births decreased from 133,957 in 2010-127,660 in 2023. Over the study period, delivery age increased from a mean 30.6 years (SD 5.5) in 2010 to 32.2 (SD 4.9) in 2023 and there was at least a doubling in the proportion of persons who delivered having preexisting/gestational diabetes (5.6% in 2010, 11.1% in 2023), obesity (1.6% in 2010, 4.6% in 2023), pre-eclampsia/eclampsia (1.1% in 2010, 2.6% in 2023), liver disorders (0.43% in 2010; 1.16% in 2023), and other diseases (4.9% in 2010, 10.7% in 2023), p < 0.0001 for all. The proportion of deliveries performed via C-section increased over time (29.3% in 2010, 34.6% in 2023) but the median length-of-stay decreased 2.68% year-over-year. Use of epidural increased non-linearly over the study period and was less likely at lower-volume hospitals. Although uncommon (<5%), the rate of obstetric trauma and birth trauma increased over the study period, regardless of the mode of delivery (p < 0.0001). Six-month mortality did not change over the study period after delivery, while infant mortality decreased (0.35% in 2010 to 0.26% in 2023). We also observed substantial hospital-level variation in utility of services including midwifery care and access to epidural.
CONCLUSION: Over the last 14 years, we found an increasing incidence of people giving birth at an older age and having complicating clinical characteristics at the time of delivery.