Maisa Feghali1, Julia Timofeev2, Chun-Chih Huang3, Rita Driggers2, Menachem Miodovnik4, Helain J Landy5, Jason G Umans6. 1. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Magee Womens Hospital of UPMC, University of Pittsburgh, Pittsburgh, PA. Electronic address: maisafeghali@gmail.com. 2. Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD. 3. MedStar Health Research Institute, Hyattsville, MD; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC. 4. Department of Women and Infants Services, MedStar Washington Hospital Center, Washington, DC; MedStar Georgetown University Hospital, Washington, DC. 5. MedStar Georgetown University Hospital, Washington, DC. 6. MedStar Health Research Institute, Hyattsville, MD; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC; MedStar Georgetown University Hospital, Washington, DC.
Abstract
OBJECTIVE: The purpose of this study was to evaluate the labor curves of patients who undergo preterm induction of labor (IOL) and to assess possible predictors of vaginal delivery (VD). STUDY DESIGN: Data from the National Institute of Child Health and Human Development Consortium on Safe Labor were analyzed. A total of 6555 women who underwent medically indicated IOL at <37 weeks of gestation were included in this analysis. Patients were divided into 4 groups based on gestational age (GA): group A, 24-27+6 weeks; B, 28-30+6 weeks; C, 31-33+6 weeks; and D, 34-36+6 weeks. Pregnant women with a contraindication to VD, IOL ≥37 weeks of gestation, and without data from cervical examination on admission were excluded. Analysis of variance was used to assess differences between GA groups. Multiple logistic regression was used to assess predictors of VD. A repeated measures analysis was used to determine average labor curves. RESULTS: Rates of vaginal live births increased with GA, from 35% (group A) to 76% (group D). Parous women (odds ratio, 6.78; 95% confidence interval, 6.38-7.21) and those with a favorable cervix at the start of IOL (odds ratio, 2.35; 95% confidence interval, 2.23-2.48) were more likely to deliver vaginally. Analysis of labor curves in nulliparous women showed shorter duration of labor with increasing GA; the active phase of labor was, however, similar across all GAs. CONCLUSION: Most women who undergo medically indicated preterm IOL between 24 and 36+6 weeks of gestation deliver vaginally. The strongest predictor of VD was parity. Preterm IOL had a limited influence on estimated labor curves across GAs.
OBJECTIVE: The purpose of this study was to evaluate the labor curves of patients who undergo preterm induction of labor (IOL) and to assess possible predictors of vaginal delivery (VD). STUDY DESIGN: Data from the National Institute of Child Health and Human Development Consortium on Safe Labor were analyzed. A total of 6555 women who underwent medically indicated IOL at <37 weeks of gestation were included in this analysis. Patients were divided into 4 groups based on gestational age (GA): group A, 24-27+6 weeks; B, 28-30+6 weeks; C, 31-33+6 weeks; and D, 34-36+6 weeks. Pregnant women with a contraindication to VD, IOL ≥37 weeks of gestation, and without data from cervical examination on admission were excluded. Analysis of variance was used to assess differences between GA groups. Multiple logistic regression was used to assess predictors of VD. A repeated measures analysis was used to determine average labor curves. RESULTS: Rates of vaginal live births increased with GA, from 35% (group A) to 76% (group D). Parous women (odds ratio, 6.78; 95% confidence interval, 6.38-7.21) and those with a favorable cervix at the start of IOL (odds ratio, 2.35; 95% confidence interval, 2.23-2.48) were more likely to deliver vaginally. Analysis of labor curves in nulliparous women showed shorter duration of labor with increasing GA; the active phase of labor was, however, similar across all GAs. CONCLUSION: Most women who undergo medically indicated preterm IOL between 24 and 36+6 weeks of gestation deliver vaginally. The strongest predictor of VD was parity. Preterm IOL had a limited influence on estimated labor curves across GAs.
Authors: Aaron B Caughey; James M Nicholson; Yvonne W Cheng; Deirdre J Lyell; A Eugene Washington Journal: Am J Obstet Gynecol Date: 2006-09 Impact factor: 8.661
Authors: Rebecca B Russell; Nancy S Green; Claudia A Steiner; Susan Meikle; Jennifer L Howse; Karalee Poschman; Todd Dias; Lisa Potetz; Michael J Davidoff; Karla Damus; Joann R Petrini Journal: Pediatrics Date: 2007-07 Impact factor: 7.124
Authors: Anna C McCormick; Jennifer J McIntosh; Weihua Gao; Judith U Hibbard; Meredith O Cruz Journal: Am J Perinatol Date: 2019-06-14 Impact factor: 1.862