Labor Induction at 39 Weeks Compared with Expectant Management in Low-Risk Parous Women...40th annual meeting of the Society for Maternal-Fetal Medicine, February 3 to 8, 2020, Grapevine, TX.
Objective Our objective was to compare outcomes among low-risk parous women who underwent elective labor induction at 39 weeks versus expectant management. Study Design This is a secondary analysis of an observational cohort of 115,502 mother–infant dyads who delivered at 25 hospitals between 2008...
| Publicado en: | American Journal of Perinatology Vol. 39; no. 5; pp. 519 - 526 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | proceedings research tables/charts Journal Article |
| Publicado: |
Thieme Medical Publishing Inc.
2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156865744&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156865744 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07351631 GQK jtl: American Journal of Perinatology issn: 07351631 maglogo: N pubinfo: dt: 2022 vid: 39 iid: 5 pid: 2811 pub: Thieme Medical Publishing Inc. place: New York, New York artinfo: ui: 156865744 156865744 156865744 10.1055/s-0040-1716711 156865744 ppf: 519 ppct: 7 formats: tig: atl: Labor Induction at 39 Weeks Compared with Expectant Management in Low-Risk Parous Women...40th annual meeting of the Society for Maternal-Fetal Medicine, February 3 to 8, 2020, Grapevine, TX. aug: au: Wagner, Stephen M. Sandoval, Grecio Grobman, William A. Bailit, Jennifer L. Wapner, Ronald J. Varner, Michael W. Thorp Jr., John M. Prasad, Mona Tita, Alan T. N. Saade, George R. Sorokin, Yoram Rouse, Dwight J. Tolosa, Jorge E. affil: Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.286, Houston, TX 77030 sug: subj: Labor, Induced Cesarean Section Pregnancy Outcomes Outcomes (Health Care) Pregnancy Complications Risk Factors Human Secondary Analysis Nonexperimental Studies Expectant Mothers Infant Hospitals Multicenter Studies Pregnancy Female Odds Ratio Multiple Logistic Regression Confidence Intervals Morbidity Descriptive Statistics Data Analysis Software Congresses and Conferences Texas Texas Infant: 1-23 months Female ab: Objective Our objective was to compare outcomes among low-risk parous women who underwent elective labor induction at 39 weeks versus expectant management. Study Design This is a secondary analysis of an observational cohort of 115,502 mother–infant dyads who delivered at 25 hospitals between 2008 and 2011. The inclusion criteria for this analysis were low-risk parous women with nonanomalous singletons with at least one prior vaginal delivery after 20 weeks, who delivered at ≥39 0/7 weeks. Women who electively induced between 39 0/7 and 39 6/7 weeks were compared with women who expectantly managed ≥39 0/7 weeks. The primary outcome for this analysis was cesarean delivery. Secondary outcomes were composites of maternal adverse outcome and neonatal adverse outcome. Multivariable logistic regression was used to estimate adjusted odds ratios (aOR). Results Of 20,822 women who met inclusion criteria, 2,648 (12.7%) were electively induced at 39 weeks. Cesarean delivery was lower among women who underwent elective induction at 39 weeks than those who did not (2.4 vs. 4.6%, adjusted odds ratio [aOR]: 0.70, 95% confidence interval [CI]: 0.53–0.92). The frequency of the composite maternal adverse outcome was significantly lower for the elective induction cohort as well (1.6 vs. 3.1%, aOR: 0.66, 95% CI: 0.47–0.93). The composite neonatal adverse outcome was not significantly different between the two groups (0.3 vs. 0.6%; aOR: 0.60, 95% CI: 0.29–1.23). Conclusion In low-risk parous women, elective induction of labor at 39 weeks was associated with decreased odds of cesarean delivery and maternal morbidity, without an increase in neonatal adverse outcomes. Key Points 39-week elective induction is associated with decreased cesarean delivery in low-risk parous women. Compared with expectant management, maternal adverse outcomes were lower with elective induction. Neonatal adverse outcomes are unchanged between elective and expectant management groups. pubtype: Academic Journal doctype: proceedings research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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