Clark SL, Fleischman A. Term pregnancy: time for a redefinition. Clin Perinatol. 2011.38:557-564. Abstract
Martin JA, Hamilton BE, Ventura SJ, et al. National Vital Statistics Reports: births: final data for 2010. http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_01.pdf. Accessed November 27, 2012.
Clark SL, Miller DD, Belfort MA, Dildy GA, Frye DK, Meyers JA. Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol. 2009;200:156.e1-e4.
Clark SL, Meyers JA, Perlin JB. Oversight of elective early term deliveries: avoiding unintended consequences. Am J Obstet Gynecol. 2012;206:387-389. Abstract
Gouyon J-B, Vintejoux A, Sagot P, et al. Neonatal outcome associated with singleton birth at 34-41 weeks of gestation. Int J Epidemiol. 2010;39:769-776. Abstract
Tita AT, Landon MB, Spong CY, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009;360:111-120. Abstract
Young PC, Glasgow TS, Li X, Guest-Warnick G, Stoddard G. Mortality of late-preterm (near-term) newborns in Utah. Pediatrics 2007; 119:e659–e565
Boyle EM, Poulsen G, Field DJ, et al. Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population-based cohort study. BMJ. 2012;344:e896.
Quigley MA, Poulsen G, Boyle E, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years: a cohort study. Arch Dis Child Fetal Neonatal. 2011;97:F167-F173.
Spong CY, Mercer BM, D’Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011. 118:323-333. Abstract
Donovan EF, Lannon C, Bailit J, et al. A statewide initiative to reduce inappropriate scheduled births at 36 (0/7)-38 (6/7) weeks' gestation. Am J Obstet Gynecol. 2012.202:243.e1-e8.
Lawrence HC. Prematurity and infant mortality: what happens when babies are born too early? http://www.acog.org/~/media/Departments/Government%20Relations%20and%20Outreach/2011LawrenceTestimony.pdf?dmc=1&ts=20121127T1141416530. Accessed November 27, 2012.

CME/CE

Reducing Elective Early-Term Birth

Authors: Deborah Campbell, MD; Siobhan Dolan, MD, MPH; Brenda Jones, DHSc, MSN, APN-BC; Hal C. Lawrence III, MD, FACOG
CME/CE Released: 12/17/2012
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 12/17/2013

Target Audience and Goal Statement

This activity is intended for primary care clinicians, OB/GYNs, pediatric providers, neonatologists, nurse-midwives, and nurses/nurse practitioners.

The goal of this activity is to discuss the risks associated with non-medically indicated early-term delivery, strategies for educating clinicians and patients about the benefits of full-term delivery and clinical conditions which may warrant an early delivery.

Upon completion of this activity, participants will be able to:

Outline the risks associated with elective, early-term birth
Discuss with patients the health reasons for taking the pregnancy to full-term
Propose instances when early-term delivery is medically appropriate

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Authors

Deborah Campbell, MD

Director, Division of Neonatology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York, New York

Disclosures

Disclosure: Deborah Campbell, MD, has disclosed no relevant financial relationships.

Dr Campbell does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Campbell does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Siobhan Dolan, MD, MPH

Associate Professor, Dept of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York

Disclosures

Disclosure: Siobhan Dolan, MD, MPH, has disclosed no relevant financial relationships.

Dr Dolan does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Dolan does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Brenda Jones, DHSc, MSN, APN-BC

Deputy Director, Office of Women's Health, Illinois Department of Public Health, Springfield, Illinois

Disclosures

Disclosure: Brenda Jones, DHSc, MSN, APN-BC, has disclosed no relevant financial relationships.

Dr Jones does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Jones does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Hal C. Lawrence III, MD, FACOG

Executive Vice President, American Congress of Obstetricians and Gynecologists, Washington, DC

Disclosures

Disclosure: Hal C. Lawrence, III, MD, FACOG, has disclosed no relevant financial relationships.

Dr Lawrence does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Lawrence does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editors

Stacey J.P. Ullman, MHS

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Stacey J.P. Ullman, MHS, has disclosed no relevant financial relationships.

Neil Chesanow

Senior Clinical Editor, Medscape, LLC

Disclosures

Disclosure: Neil Chesanow has disclosed no relevant financial relationships.

CME Reviewer

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

Nurse Planner

Laurie E. Scudder, DNP, NP

Nurse Planner, Continuing Professional Education Department, Medscape, LLC; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC

Disclosures

Disclosure: Laurie E. Scudder, DNP, NP, has disclosed no relevant financial relationships.

Accreditation Statements

For Physicians

Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medscape, LLC designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Contact This Provider

For Nurses

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Awarded 0.5 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.

Accreditation of this program does not imply endorsement by either Medscape, LLC or ANCC.

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For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read the target audience, learning objectives, and author disclosures.
Study the educational content online or printed out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

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From Medscape Education Business of Medicine

CME/CE

Reducing Elective Early-Term Birth

Authors: Deborah Campbell, MD; Siobhan Dolan, MD, MPH; Brenda Jones, DHSc, MSN, APN-BC; Hal C. Lawrence III, MD, FACOGFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME/CE Released: 12/17/2012

Valid for credit through: 12/17/2013

processing....

Abbreviations

ACOG = American Congress of Obstetricians and Gynecologists
AAP = American Academy of Pediatrics
CHIP = Children's Health Insurance Program
CMS = Centers for Medicare & Medicaid Services
HCA = Hospital Corporation of America
HELLP = hemolysis, elevated liver enzymes, low platelet count
HHS = Department of Health and Human Services
IUGR = intrauterine fetal growth restriction
MOD = March of Dimes
NICHD = National Institute of Child Health & Human Development
NICU = neonatal intensive care unit
PROM = premature rupture of the membranes

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References

Faculty and Disclosures

Authors

Deborah Campbell, MD

Siobhan Dolan, MD, MPH

Brenda Jones, DHSc, MSN, APN-BC

Hal C. Lawrence III, MD, FACOG

Editors

Stacey J.P. Ullman, MHS

Neil Chesanow

CME Reviewer

Nafeez Zawahir, MD

Nurse Planner

Laurie E. Scudder, DNP, NP

CME/CE

Reducing Elective Early-Term Birth

Target Audience and Goal Statement

Disclosures

Authors

Deborah Campbell, MD

Siobhan Dolan, MD, MPH

Brenda Jones, DHSc, MSN, APN-BC

Hal C. Lawrence III, MD, FACOG

Editors

Stacey J.P. Ullman, MHS

Neil Chesanow

CME Reviewer

Nafeez Zawahir, MD

Nurse Planner

Laurie E. Scudder, DNP, NP

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Reducing Elective Early-Term Birth

Abbreviations