Maternal and neonatal outcomes by labor onset type and gestational age

Jennifer L. Bailit*, Kimberly D. Gregory, Uma M. Reddy, Victor H. Gonzalez-Quintero, Judith U. Hibbard, Mildred M. Ramirez, D. Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G. Hatjis, Matthew K. Hoffman, Michelle Kominiarek, Helain J. Landy, Lee A. Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

*Corresponding author for this work

Research output: Contribution to journalArticle

93 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)245.e1-245.e12
JournalAmerican journal of obstetrics and gynecology
Volume202
Issue number3
DOIs
StatePublished - Jan 1 2010

Fingerprint

Labor Onset
Gestational Age
Mothers
Confidence Intervals
Neonatal Intensive Care Units
Odds Ratio
Hysterectomy
Sepsis
Induced Labor
Electronic Health Records
Mechanical Ventilators

Keywords

  • elective delivery
  • hysterectomy
  • maternal outcomes
  • neonatal outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Bailit, J. L., Gregory, K. D., Reddy, U. M., Gonzalez-Quintero, V. H., Hibbard, J. U., Ramirez, M. M., ... Zhang, J. (2010). Maternal and neonatal outcomes by labor onset type and gestational age. American journal of obstetrics and gynecology, 202(3), 245.e1-245.e12. https://doi.org/10.1016/j.ajog.2010.01.051
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. / Maternal and neonatal outcomes by labor onset type and gestational age. In: American journal of obstetrics and gynecology. 2010 ; Vol. 202, No. 3. pp. 245.e1-245.e12.
@article{f6dd5f319f564b66852c32ed34e5e2cf,
title = "Maternal and neonatal outcomes by labor onset type and gestational age",
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.",
keywords = "elective delivery, hysterectomy, maternal outcomes, neonatal outcomes",
author = "Bailit, {Jennifer L.} and Gregory, {Kimberly D.} and Reddy, {Uma M.} and Gonzalez-Quintero, {Victor H.} and Hibbard, {Judith U.} and Ramirez, {Mildred M.} and Branch, {D. Ware} and Ronald Burkman and Shoshana Haberman and Hatjis, {Christos G.} and Hoffman, {Matthew K.} and Michelle Kominiarek and Landy, {Helain J.} and Learman, {Lee A.} and James Troendle and {Van Veldhuisen}, Paul and Isabelle Wilkins and Liping Sun and Jun Zhang",
year = "2010",
month = "1",
day = "1",
doi = "10.1016/j.ajog.2010.01.051",
language = "English (US)",
volume = "202",
pages = "245.e1--245.e12",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

Bailit, JL, Gregory, KD, Reddy, UM, Gonzalez-Quintero, VH, Hibbard, JU, Ramirez, MM, Branch, DW, Burkman, R, Haberman, S, Hatjis, CG, Hoffman, MK, Kominiarek, M, Landy, HJ, Learman, LA, Troendle, J, Van Veldhuisen, P, Wilkins, I, Sun, L & Zhang, J 2010, 'Maternal and neonatal outcomes by labor onset type and gestational age', American journal of obstetrics and gynecology, vol. 202, no. 3, pp. 245.e1-245.e12. https://doi.org/10.1016/j.ajog.2010.01.051

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 journalArticle

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 -

Bailit JL, Gregory KD, Reddy UM, Gonzalez-Quintero VH, Hibbard JU, Ramirez MM et al. Maternal and neonatal outcomes by labor onset type and gestational age. American journal of obstetrics and gynecology. 2010 Jan 1;202(3):245.e1-245.e12. https://doi.org/10.1016/j.ajog.2010.01.051