Timing of delivery and pregnancy outcomes among laboring nulliparous women

Alan Thevenet N Tita, Yinglei Lai, Steven L. Bloom, Catherine Y. Spong, Michael W. Varner, Susan M. Ramin, Steve N. Caritis, William A. Grobman, Yoram Sorokin, Anthony Sciscione, Marshall W. Carpenter, Brian M. Mercer, John M. Thorp, Fergal D. Malone, Margaret Harper, Jay D. Iams

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)239.e1-239.e8
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Mar 2012


  • cesarean delivery
  • labor
  • nulliparous
  • optimal timing of delivery
  • pregnancy outcomes

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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