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The cesarean delivery rate for singleton preterm births increased 47%, and the rate of induced labor doubled. In 2006, 51% of singleton preterm births were spontaneous vaginal deliveries, compared with 69% in 1991. After adjustment for demographic and medical risks, the mother of a preterm infant was 88% (95% confidence interval [CI] = 1.87, 1.90) more likely to have an obstetrical intervention in 2006 than in 1991. Using new birth certificate data from 19 states, we estimated that 42% of singleton preterm infants were delivered via induction or cesarean birth without spontaneous onset of labor. <\/jats:p><jats:p> Conclusions. Obstetrical interventions were related to the increase in the US preterm birth rate between 1991 and 2006. The public health community can play a central role in reducing medically unnecessary interventions. <\/jats:p>","DOI":"10.2105\/ajph.2009.180570","type":"journal-article","created":{"date-parts":[[2010,9,24]],"date-time":"2010-09-24T03:49:58Z","timestamp":1285300198000},"page":"2241-2247","source":"Crossref","is-referenced-by-count":73,"title":["Obstetrical Intervention and the Singleton Preterm Birth Rate in the United States From 1991\u20132006"],"prefix":"10.2105","volume":"100","author":[{"given":"Marian F.","family":"MacDorman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Declercq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"issue":"7","key":"bib1","volume":"57","author":"Martin 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