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Am J Obstet Gynecol. 2012 Mar;206(3):239.e1-8. doi: 10.1016/j.ajog.2011.12.006. Epub 2011 Dec 16.

Timing of delivery and pregnancy outcomes among laboring nulliparous women.

Author information

1
Department of Obstetrics at University of Alabama School of Medicine at Birmingham, Birmingham, AL, USA.

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.

PMID:
22244471
PMCID:
PMC3292690
DOI:
10.1016/j.ajog.2011.12.006
[Indexed for MEDLINE]
Free PMC Article

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