Document Detail


Neonatal and maternal outcomes associated with elective term delivery.
MedLine Citation:
PMID:  19110225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To quantify adverse neonatal and maternal outcomes associated with elective term delivery at less than 39 completed weeks of gestation. STUDY DESIGN: Prospective observational study conducted in 27 hospitals over the course of 3 months in 2007. RESULTS: Of 17,794 deliveries, 14,955 (84%) occurred at 37 weeks or greater. Of term deliveries, 6562 (44%) were planned, rather than spontaneous. Among the planned deliveries, 4645 (71%) were purely elective; 17.8% of infants delivered electively without medical indication at 37-38 weeks and 8% of those delivered electively at 38-39 weeks required admission to a newborn special care unit for an average of 4.5 days, compared with 4.6% of infants delivered at 39 weeks or beyond (P < .001). Cesarean delivery rate in women undergoing induction of labor was not influenced by gestational age but was highly influenced by initial cervical dilatation and parity, ranging from 0% for parous women induced at 5 cm or greater to 50% for nulliparous women at 0 cm. CONCLUSION: Elective delivery before 39 weeks' gestation is associated with significant neonatal morbidity. Initial cervical dilatation is highly correlated with cesarean delivery among women undergoing induction of labor in both nulliparous and parous women. Elective delivery before 39 completed weeks' gestation is inappropriate. Women contemplating elective induction at or beyond 39 weeks' gestation with an unfavorable cervix should be counseled regarding an increased rate of cesarean delivery.
Authors:
Steven L Clark; Darla D Miller; Michael A Belfort; Gary A Dildy; Donna K Frye; Janet A Meyers
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-12-25
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  200     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156.e1-4     Citation Subset:  AIM; IM    
Affiliation:
Hospital Corporation of America, Nashville, TN, USA.
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MeSH Terms
Descriptor/Qualifier:
Delivery, Obstetric / statistics & numerical data*
Female
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome
Surgical Procedures, Elective / statistics & numerical data
Term Birth*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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