Timing of delivery and pregnancy outcomes among laboring nulliparous women.

Abstract

OBJECTIVE:

The objective of the study was to compare pregnancy outcomes by completed week of gestation after 39 weeks with outcomes at 39 weeks.

STUDY DESIGN:

Secondary analysis of a multicenter trial of fetal pulse oximetry in spontaneously laboring or induced nulliparous women at a gestation of 36 weeks or longer. Maternal outcomes included a composite (treated uterine atony, blood transfusion, and peripartum infections) and cesarean delivery. Neonatal outcomes included a composite of death, neonatal respiratory and other morbidities, and neonatal intensive care unit admission.

RESULTS:

Among the 4086 women studied, the risks of the composite maternal outcome (P value for trend < .001), cesarean delivery (P < .001), and composite neonatal outcome (P = .047) increased with increasing gestational age from 39 to 41 or more completed weeks. Adjusted odds ratios (95% confidence interval) for 40 and 41 or more weeks, respectively, compared with 39 weeks were 1.29 (1.03-1.64) and 2.05 (1.60-2.64) for composite maternal outcome, 1.28 (1.05-1.57) and 1.75 (1.41-2.16) for cesarean delivery, and 1.25 (0.86-1.83) and 1.37 (0.90-2.09) for composite neonatal outcome.

CONCLUSION:

Risks of maternal morbidity and cesarean delivery but not neonatal morbidity increased significantly beyond 39 weeks.

• Authors: Alan Thevenet N Tita, Yinglei Lai, Steven L Bloom, Catherine Y Spong, Michael W Varner, Susan M Ramin, Steve N Caritis, William A Grobman, Yoram Sorokin, Anthony Sciscione, Marshall W Carpenter, Brian M Mercer, John M Thorp Jr, Fergal D Malone, Margaret Harper, Jay D Iams
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 206 Issue 3 Pg. 239.e1-8 (Mar 2012) ISSN: 1097-6868 [Electronic] United States
• PMID: 22244471 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2012 Mosby, Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Delivery, Obstetric
• Female
• Humans
• Infant Mortality
• Infant, Newborn
• Male
• Multicenter Studies as Topic
• Oximetry
• Parity
• Pregnancy
• Pregnancy Outcome
• Risk
• Time Factors
• Young Adult