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Neonatal and maternal outcomes associated with elective term delivery
Steven L Clark1, Darla D Miller, Michael A Belfort
1Hospital Corporation of America, Nashville, TN, USA.
American Journal of Obstetrics and Gynecology
|December 27, 2008
Summary
Elective delivery before 39 weeks gestation increases newborn special care admissions. Counseling is advised for elective induction at 39 weeks with an unfavorable cervix due to higher cesarean rates.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Maternal-Fetal Medicine
Background:
- Term delivery before 39 completed weeks is common.
- Understanding risks of elective delivery is crucial for optimal outcomes.
Purpose of the Study:
- To quantify adverse neonatal and maternal outcomes associated with elective term delivery before 39 completed weeks of gestation.
Main Methods:
- Prospective observational study.
- Conducted in 27 hospitals.
- Included 17,794 deliveries.
Main Results:
- Elective delivery before 39 weeks significantly increased newborn special care unit admissions (17.8% at 37-38 weeks, 8% at 38-39 weeks) compared to delivery at 39+ weeks (4.6%).
- Cesarean delivery rates during induction were not influenced by gestational age but strongly correlated with cervical dilatation and parity.
- 0% cesarean for parous women induced at 5cm+ dilation vs. 50% for nulliparous women at 0cm.
Conclusions:
- Elective delivery before 39 weeks is linked to increased neonatal morbidity.
- Cervical dilatation and parity are key factors in cesarean rates during labor induction.
- Elective delivery before 39 weeks is inappropriate; counseling on cesarean risks is vital for inductions at 39+ weeks with unfavorable cervix.
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