Timing of delivery and pregnancy outcomes among laboring nulliparous women

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

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume206
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Pregnancy Outcome
Mothers
Morbidity
Uterine Inertia
Peripartum Period
Pregnancy
Oximetry
Neonatal Intensive Care Units
Blood Transfusion
Gestational Age
Multicenter Studies
Odds Ratio
Confidence Intervals
Infection

Keywords

  • cesarean delivery
  • labor
  • nulliparous
  • optimal timing of delivery
  • pregnancy outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Timing of delivery and pregnancy outcomes among laboring nulliparous women. / Tita, Alan Thevenet N; Lai, Yinglei; Bloom, Steven L.; Spong, Catherine Y.; Varner, Michael W.; Ramin, Susan M.; Caritis, Steve N.; Grobman, William A.; Sorokin, Yoram; Sciscione, Anthony; Carpenter, Marshall W.; Mercer, Brian M.; Thorp, John M.; Malone, Fergal D.; Harper, Margaret; Iams, Jay D.

In: American Journal of Obstetrics and Gynecology, Vol. 206, No. 3, 03.2012.

Research output: Contribution to journalArticle

Tita, ATN, Lai, Y, Bloom, SL, Spong, CY, Varner, MW, Ramin, SM, Caritis, SN, Grobman, WA, Sorokin, Y, Sciscione, A, Carpenter, MW, Mercer, BM, Thorp, JM, Malone, FD, Harper, M & Iams, JD 2012, 'Timing of delivery and pregnancy outcomes among laboring nulliparous women', American Journal of Obstetrics and Gynecology, vol. 206, no. 3. https://doi.org/10.1016/j.ajog.2011.12.006
Tita, Alan Thevenet N ; Lai, Yinglei ; Bloom, Steven L. ; Spong, Catherine Y. ; Varner, Michael W. ; Ramin, Susan M. ; Caritis, Steve N. ; Grobman, William A. ; Sorokin, Yoram ; Sciscione, Anthony ; Carpenter, Marshall W. ; Mercer, Brian M. ; Thorp, John M. ; Malone, Fergal D. ; Harper, Margaret ; Iams, Jay D. / Timing of delivery and pregnancy outcomes among laboring nulliparous women. In: American Journal of Obstetrics and Gynecology. 2012 ; Vol. 206, No. 3.
@article{f9d36ee1c3364622b334c069f83149f4,
title = "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.",
keywords = "cesarean delivery, labor, nulliparous, optimal timing of delivery, pregnancy outcomes",
author = "Tita, {Alan Thevenet N} and Yinglei Lai and Bloom, {Steven L.} and Spong, {Catherine Y.} and Varner, {Michael W.} and Ramin, {Susan M.} and Caritis, {Steve N.} and Grobman, {William A.} and Yoram Sorokin and Anthony Sciscione and Carpenter, {Marshall W.} and Mercer, {Brian M.} and Thorp, {John M.} and Malone, {Fergal D.} and Margaret Harper and Iams, {Jay D.}",
year = "2012",
month = "3",
doi = "10.1016/j.ajog.2011.12.006",
language = "English (US)",
volume = "206",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Timing of delivery and pregnancy outcomes among laboring nulliparous women

AU - Tita, Alan Thevenet N

AU - Lai, Yinglei

AU - Bloom, Steven L.

AU - Spong, Catherine Y.

AU - Varner, Michael W.

AU - Ramin, Susan M.

AU - Caritis, Steve N.

AU - Grobman, William A.

AU - Sorokin, Yoram

AU - Sciscione, Anthony

AU - Carpenter, Marshall W.

AU - Mercer, Brian M.

AU - Thorp, John M.

AU - Malone, Fergal D.

AU - Harper, Margaret

AU - Iams, Jay D.

PY - 2012/3

Y1 - 2012/3

N2 - 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.

AB - 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.

KW - cesarean delivery

KW - labor

KW - nulliparous

KW - optimal timing of delivery

KW - pregnancy outcomes

UR - http://www.scopus.com/inward/record.url?scp=84857791801&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84857791801&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2011.12.006

DO - 10.1016/j.ajog.2011.12.006

M3 - Article

C2 - 22244471

AN - SCOPUS:84857791801

VL - 206

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 3

ER -