Document Detail


The impact of the active management of risk in pregnancy at term on birth outcomes: a randomized clinical trial.
MedLine Citation:
PMID:  18455526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
James M Nicholson; Samuel Parry; Aaron B Caughey; Sarah Rosen; Allison Keen; George A Macones
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  198     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-05     Completed Date:  2008-05-27     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  511.e1-15     Citation Subset:  AIM; IM    
Affiliation:
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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:
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 ]
Am J Obstet Gynecol. 2009 Apr;200(4):e12; author reply e12-3   [PMID:  18845291 ]

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


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