| The impact of the active management of risk in pregnancy at term on birth outcomes: a randomized clinical trial. | |
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MedLine Citation:
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PMID: 18455526 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to compare birth outcomes that result from the active management of risk in pregnancy at term (AMOR-IPAT) to those outcomes that result from standard management. STUDY DESIGN: This was a randomized clinical trial with 270 women of mixed parity. AMOR-IPAT used preventive labor induction to ensure delivery before the end of an estimated optimal time of delivery. Rates of 4 adverse obstetric events and 2 composite measures were used to evaluate birth outcomes. RESULTS: The AMOR-IPAT-exposed group had a similar cesarean delivery rate (10.3% vs 14.9%; P = .25), but a lower neonatal intensive care unit admission rate (1.5% vs 6.7%; P = .03), a higher uncomplicated vaginal birth rate (73.5% vs 62.8%; P = .046), and a lower mean Adverse Outcome Index score (1.4 vs 8.6; P = .03). CONCLUSION: AMOR-IPAT exposure improved the pattern of birth outcomes. Larger randomized clinical trials are needed to explore further the impact of AMOR-IPAT on birth outcomes and to determine the best methods of preventive labor induction. |
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Authors:
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James M Nicholson; Samuel Parry; Aaron B Caughey; Sarah Rosen; Allison Keen; George A Macones |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 198 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-05 Completed Date: 2008-05-27 Revised Date: 2010-09-21 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 511.e1-15 Citation Subset: AIM; IM |
Affiliation:
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Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cesarean Section / statistics & numerical data* Female Gestational Age Humans Intensive Care Units, Neonatal / statistics & numerical data Labor, Induced / statistics & numerical data* Odds Ratio Physician's Practice Patterns / statistics & numerical data* Pregnancy Pregnancy Outcome* Pregnancy, High-Risk* Proportional Hazards Models Urban Population / statistics & numerical data |
| Grant Support | |
ID/Acronym/Agency:
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K23 HD042043-01/HD/NICHD NIH HHS; K23 HD042043-02/HD/NICHD NIH HHS; K23 HD042043-03/HD/NICHD NIH HHS; K23 HD042043-04/HD/NICHD NIH HHS; K23 HD042043-05/HD/NICHD NIH HHS; K23-HD-42043/HD/NICHD NIH HHS |
| Comments/Corrections | |
Comment In:
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Am J Obstet Gynecol. 2009 Apr;200(4):e12; author reply e12-3
[PMID:
18845291
]
Evid Based Med. 2009 Feb;14(1):17 [PMID: 19181949 ] Am J Obstet Gynecol. 2009 Apr;200(4):e13-4; author reply e14 [PMID: 18823874 ] |
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