Abstract
Objective: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age. Study Design: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age. Results: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor. Conclusion: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction are associated with better neonatal outcomes compared to spontaneous labor. Elective induction may be associated with an increased hysterectomy risk.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 245.e1-245.e12 |
| Journal | American journal of obstetrics and gynecology |
| Volume | 202 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jan 1 2010 |
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Keywords
- elective delivery
- hysterectomy
- maternal outcomes
- neonatal outcomes
ASJC Scopus subject areas
- Obstetrics and Gynecology
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Maternal and neonatal outcomes by labor onset type and gestational age. / Bailit, Jennifer L.; Gregory, Kimberly D.; Reddy, Uma M.; Gonzalez-Quintero, Victor H.; Hibbard, Judith U.; Ramirez, Mildred M.; Branch, D. Ware; Burkman, Ronald; Haberman, Shoshana; Hatjis, Christos G.; Hoffman, Matthew K.; Kominiarek, Michelle; Landy, Helain J.; Learman, Lee A.; Troendle, James; Van Veldhuisen, Paul; Wilkins, Isabelle; Sun, Liping; Zhang, Jun.
In: American journal of obstetrics and gynecology, Vol. 202, No. 3, 01.01.2010, p. 245.e1-245.e12.Research output: Contribution to journal › Article
TY - JOUR
T1 - Maternal and neonatal outcomes by labor onset type and gestational age
AU - Bailit, Jennifer L.
AU - Gregory, Kimberly D.
AU - Reddy, Uma M.
AU - Gonzalez-Quintero, Victor H.
AU - Hibbard, Judith U.
AU - Ramirez, Mildred M.
AU - Branch, D. Ware
AU - Burkman, Ronald
AU - Haberman, Shoshana
AU - Hatjis, Christos G.
AU - Hoffman, Matthew K.
AU - Kominiarek, Michelle
AU - Landy, Helain J.
AU - Learman, Lee A.
AU - Troendle, James
AU - Van Veldhuisen, Paul
AU - Wilkins, Isabelle
AU - Sun, Liping
AU - Zhang, Jun
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Objective: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age. Study Design: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age. Results: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor. Conclusion: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction are associated with better neonatal outcomes compared to spontaneous labor. Elective induction may be associated with an increased hysterectomy risk.
AB - Objective: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age. Study Design: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age. Results: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor. Conclusion: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction are associated with better neonatal outcomes compared to spontaneous labor. Elective induction may be associated with an increased hysterectomy risk.
KW - elective delivery
KW - hysterectomy
KW - maternal outcomes
KW - neonatal outcomes
UR - http://www.scopus.com/inward/record.url?scp=77649283322&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77649283322&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2010.01.051
DO - 10.1016/j.ajog.2010.01.051
M3 - Article
C2 - 20207242
AN - SCOPUS:77649283322
VL - 202
SP - 245.e1-245.e12
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
SN - 0002-9378
IS - 3
ER -