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

Research output: Contribution to journalArticle

97 Scopus citations

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 - Mar 2010

Keywords

  • elective delivery
  • hysterectomy
  • maternal outcomes
  • neonatal outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Bailit, J. L., Gregory, K. D., Reddy, U. M., Gonzalez-Quintero, V. H., Hibbard, J. U., Ramirez, M. M., Branch, D. W., Burkman, R., Haberman, S., Hatjis, C. G., Hoffman, M. K., Kominiarek, M., Landy, H. J., Learman, L. A., 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, 202(3), 245.e1-245.e12. https://doi.org/10.1016/j.ajog.2010.01.051