What Is the Best Strategy for Lowering Rates of Elective Early-Term Deliveries?

Delivery before 39 weeks' gestation is associated with substantial neonatal morbidity, even with demonstrated fetal lung maturity (JW Womens Health Dec 16 2010). Investigators assessed the effectiveness of three approaches to lowering rates of elective delivery before 39 weeks:

1. “Hard stop,” in which purely elective deliveries before 39 weeks were prohibited according to a policy enforced by hospital personnel

2. “Soft stop,” characterized by voluntary adherence and peer review of exceptions

3. Staff education only, with no formal policy prohibiting elective deliveries before 39 weeks

Information about delivery modes and outcomes at 27 hospitals in 14 U.S. states was obtained from the Hospital Corporation of America database; preventive strat…