Document Detail


Timing of delivery and pregnancy outcomes among laboring nulliparous women.
MedLine Citation:
PMID:  22244471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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; Fergal D Malone; Margaret Harper; Jay D Iams
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-12-16
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  206     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-02     Completed Date:  2012-04-24     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239.e1-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Department of Obstetrics at University of Alabama School of Medicine at Birmingham, Birmingham, AL, USA.
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MeSH Terms
Descriptor/Qualifier:
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
Grant Support
ID/Acronym/Agency:
HD21410/HD/NICHD NIH HHS; HD27860/HD/NICHD NIH HHS; HD27869/HD/NICHD NIH HHS; HD27915/HD/NICHD NIH HHS; HD27917/HD/NICHD NIH HHS; HD34116/HD/NICHD NIH HHS; HD34136/HD/NICHD NIH HHS; HD34208/HD/NICHD NIH HHS; HD36801/HD/NICHD NIH HHS; HD40485/HD/NICHD NIH HHS; HD40500/HD/NICHD NIH HHS; HD40512/HD/NICHD NIH HHS; HD40544/HD/NICHD NIH HHS; HD40545/HD/NICHD NIH HHS; HD40560/HD/NICHD NIH HHS; R24 HD050924/HD/NICHD NIH HHS; U10 HD027869/HD/NICHD NIH HHS; U10 HD027869-20/HD/NICHD NIH HHS; UL1 RR024989/RR/NCRR NIH HHS
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