Maternal obstructive sleep apnea and neonatal birth outcomes in a population based sample.

Objective: Evaluate the association of OSA with birth outcomes including the risk of congenital anomalies and the need for a higher level of clinical care at delivery.

Methods: Population-based study that linked newborn records with maternal records. Data from 95 perinatal centers across all geographic census divisions of the U.

Development and Validation of a Risk Prediction Model for Cesarean Delivery After Labor Induction.

The goal of the study was to develop and validate a prediction model for cesarean delivery after labor induction that included factors known before the start of induction, unlike prior studies that focused on characteristics at the time of induction. Using 17,370 term labor inductions without documented medical indications occurring at 14 U.S.

Feasibility of AWHONN's Immediate and Continuous Skin-to-Skin Nursing Care Quality Measures.

Use of skin-to-skin contact after birth supports a newborn's physiologic transition from intra- to extrauterine life, mother-infant bonding, and the initiation of breastfeeding. Nursing Care Quality Measures 3 and 4 (Skin-to-Skin is Initiated Immediately Following Birth and Duration of Uninterrupted Skin-to-Skin Contact) from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) were developed to support quality improvement efforts to increase skin-to-skin contact. AWHONN's nursing care quality measures were found to be feasible in hospitals in which medical records were configured to document the start and stop times of skin-to-skin contact.

Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.

Background: The Safety Program for Perinatal Care (SPPC) seeks to improve safety on labor and delivery (L&D) units through three mutually reinforcing components: (1) fostering a culture of teamwork and communication, (2) applying safety science principles to care processes; and (3) in situ simulation. The objective of this study was to describe the SPPC implementation experience and evaluate the short-term impact on unit patient safety culture, processes, and adverse events.

Methods: We supported SPPC implementation by L&D units with a program toolkit, trainings, and technical assistance.

Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort.

Objective: Pregnancy and the obesity epidemic impacting women of reproductive age appear to predispose women to obstructive sleep apnea (OSA) in pregnancy. The aim of this study is to examine the association between OSA and adverse maternal outcomes in a national cohort.

Methods: The National Perinatal Information Center in the US was used to identify women with a delivery discharge diagnosis of OSA from 2010 to 2014.

Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes.

Objective: To define, measure, and characterize key competencies of managing labor and delivery units in the United States and assess the associations between unit management and maternal outcomes.

Methods: We developed and administered a management measurement instrument using structured telephone interviews with both the primary nurse and physician managers at 53 diverse hospitals across the United States. A trained interviewer scored the managers' interview responses based on management practices that ranged from most reactive (lowest scores) to most proactive (highest scores).

Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform.

Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates.

Integrated Approach to Reduce Perinatal Adverse Events: Standardized Processes, Interdisciplinary Teamwork Training, and Performance Feedback.

Objective: To improve safety practices and reduce adverse events in perinatal units of acute care hospitals.

Data Sources: Primary data collected from perinatal units of 14 hospitals participating in the intervention between 2008 and 2012. Baseline secondary data collected from the same hospitals between 2006 and 2007.

Comparing expectant management and spontaneous labor approaches in studying the effect of labor induction on cesarean delivery.

Purpose: Evidence of the impact of labor induction on cesarean delivery (CD) remains inconclusive because of differing methodological approaches. A spontaneous labor comparison group describes patterns retrospectively, whereas an expectant management comparison group prospectively evaluates a decision to induce. We examined the influence of comparison group on the association between labor induction and CD.

Hospital differences in special care nursery use for newborns of gestational diabetic mothers.

Objective: Relatively healthy newborns of mothers with gestational diabetes mellitus (GDM) sometimes receive unwarranted surveillance. We studied the relationship between hospital characteristics and special care nursery use and total length of stay among GDM deliveries.

Methods: We identified GDM deliveries at 44 USA member hospitals of the National Perinatal Information Center from 2007 to 2011.