Hypertension and patterns of induced labor at term

Julia M. Bregand-White*, Michelle Kominiarek, Judith U. Hibbard

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective To study patterns of induced labor at term in hypertensive women. Study design We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n = 1164), gestational hypertension (n = 1861), preeclampsia (n = 1513) and superimposed preeclampsia (n = 655), compared to controls (no hypertension, n = 50,379). Labor characteristics and patterns were compared among the groups, stratified by parity. Main outcome measures Interval-censored regression analysis estimated median and 95th% duration of labor, stratified by centimeter-by-centimeter dilation. Repeated-measures analysis established mean labor curves. Results Time to progress from 4 to 10 cm was 7.5, 6.4, 4.9 and 4.6 h in nulliparous women with superimposed preeclampsia, chronic hypertension, preeclampsia and gestational hypertension respectively, which differed from controls (4.9 h; p < 0.05 for chronic hypertension and superimposed preeclampsia). Multiparous women required 3.8, 3.9, 3.2 and 3.3 h, respectively, compared to controls (3.2 h, p < 0.05 except preeclampsia p = 0.1) to progress from 4 to 10 cm. Second stage of labor without epidural was longer for all nulliparous groups compared to controls except for women with chronic hypertension, but second stage did not differ in multiparas. Conclusion Regardless of parity, women with chronic disease, chronic hypertension and superimposed preeclampsia, labor longer whereas those with relatively acute disease, gestational hypertension and preeclampsia, progress more rapidly.

Original languageEnglish (US)
Pages (from-to)57-63
Number of pages7
JournalPregnancy Hypertension
Volume10
DOIs
StatePublished - Oct 1 2017

Fingerprint

Induced Labor
Pre-Eclampsia
Hypertension
Pregnancy Induced Hypertension
Parity
Second Labor Stage
Electronic Health Records
Acute Disease
Multicenter Studies
Dilatation
Fetus
Chronic Disease
Cohort Studies
Retrospective Studies
Regression Analysis
Outcome Assessment (Health Care)
Databases

Keywords

  • Hypertension
  • Induction
  • Labor
  • Preeclampsia

ASJC Scopus subject areas

  • Internal Medicine
  • Obstetrics and Gynecology

Cite this

Bregand-White, Julia M. ; Kominiarek, Michelle ; Hibbard, Judith U. / Hypertension and patterns of induced labor at term. In: Pregnancy Hypertension. 2017 ; Vol. 10. pp. 57-63.
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abstract = "Objective To study patterns of induced labor at term in hypertensive women. Study design We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n = 1164), gestational hypertension (n = 1861), preeclampsia (n = 1513) and superimposed preeclampsia (n = 655), compared to controls (no hypertension, n = 50,379). Labor characteristics and patterns were compared among the groups, stratified by parity. Main outcome measures Interval-censored regression analysis estimated median and 95th{\%} duration of labor, stratified by centimeter-by-centimeter dilation. Repeated-measures analysis established mean labor curves. Results Time to progress from 4 to 10 cm was 7.5, 6.4, 4.9 and 4.6 h in nulliparous women with superimposed preeclampsia, chronic hypertension, preeclampsia and gestational hypertension respectively, which differed from controls (4.9 h; p < 0.05 for chronic hypertension and superimposed preeclampsia). Multiparous women required 3.8, 3.9, 3.2 and 3.3 h, respectively, compared to controls (3.2 h, p < 0.05 except preeclampsia p = 0.1) to progress from 4 to 10 cm. Second stage of labor without epidural was longer for all nulliparous groups compared to controls except for women with chronic hypertension, but second stage did not differ in multiparas. Conclusion Regardless of parity, women with chronic disease, chronic hypertension and superimposed preeclampsia, labor longer whereas those with relatively acute disease, gestational hypertension and preeclampsia, progress more rapidly.",
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Hypertension and patterns of induced labor at term. / Bregand-White, Julia M.; Kominiarek, Michelle; Hibbard, Judith U.

In: Pregnancy Hypertension, Vol. 10, 01.10.2017, p. 57-63.

Research output: Contribution to journalArticle

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T1 - Hypertension and patterns of induced labor at term

AU - Bregand-White, Julia M.

AU - Kominiarek, Michelle

AU - Hibbard, Judith U.

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N2 - Objective To study patterns of induced labor at term in hypertensive women. Study design We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n = 1164), gestational hypertension (n = 1861), preeclampsia (n = 1513) and superimposed preeclampsia (n = 655), compared to controls (no hypertension, n = 50,379). Labor characteristics and patterns were compared among the groups, stratified by parity. Main outcome measures Interval-censored regression analysis estimated median and 95th% duration of labor, stratified by centimeter-by-centimeter dilation. Repeated-measures analysis established mean labor curves. Results Time to progress from 4 to 10 cm was 7.5, 6.4, 4.9 and 4.6 h in nulliparous women with superimposed preeclampsia, chronic hypertension, preeclampsia and gestational hypertension respectively, which differed from controls (4.9 h; p < 0.05 for chronic hypertension and superimposed preeclampsia). Multiparous women required 3.8, 3.9, 3.2 and 3.3 h, respectively, compared to controls (3.2 h, p < 0.05 except preeclampsia p = 0.1) to progress from 4 to 10 cm. Second stage of labor without epidural was longer for all nulliparous groups compared to controls except for women with chronic hypertension, but second stage did not differ in multiparas. Conclusion Regardless of parity, women with chronic disease, chronic hypertension and superimposed preeclampsia, labor longer whereas those with relatively acute disease, gestational hypertension and preeclampsia, progress more rapidly.

AB - Objective To study patterns of induced labor at term in hypertensive women. Study design We performed a retrospective cohort study using the Consortium on Safe Labor database; a multicenter study of labor and delivery practices from electronic medical records in 19 hospitals. 55,572 women were studied: 28,254 nulliparas and 27,318 multiparas, undergoing induction of labor at term without a prior cesarean with a singleton vertex live born fetus. Four hypertensive groups were defined: chronic hypertension (n = 1164), gestational hypertension (n = 1861), preeclampsia (n = 1513) and superimposed preeclampsia (n = 655), compared to controls (no hypertension, n = 50,379). Labor characteristics and patterns were compared among the groups, stratified by parity. Main outcome measures Interval-censored regression analysis estimated median and 95th% duration of labor, stratified by centimeter-by-centimeter dilation. Repeated-measures analysis established mean labor curves. Results Time to progress from 4 to 10 cm was 7.5, 6.4, 4.9 and 4.6 h in nulliparous women with superimposed preeclampsia, chronic hypertension, preeclampsia and gestational hypertension respectively, which differed from controls (4.9 h; p < 0.05 for chronic hypertension and superimposed preeclampsia). Multiparous women required 3.8, 3.9, 3.2 and 3.3 h, respectively, compared to controls (3.2 h, p < 0.05 except preeclampsia p = 0.1) to progress from 4 to 10 cm. Second stage of labor without epidural was longer for all nulliparous groups compared to controls except for women with chronic hypertension, but second stage did not differ in multiparas. Conclusion Regardless of parity, women with chronic disease, chronic hypertension and superimposed preeclampsia, labor longer whereas those with relatively acute disease, gestational hypertension and preeclampsia, progress more rapidly.

KW - Hypertension

KW - Induction

KW - Labor

KW - Preeclampsia

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