Table 5.
Secondary outcomes in all study patients
| Outcome | PRE n=2672 | POST n=2526 | P value or adjusted odds ratio (95% CI) |
|---|---|---|---|
| Maternal | |||
| Epidural | 1728 (64.7) | 1698 (67.2) | .06 |
| CD | 699 (26.2) | 626 (24.8) | 0.974 (0.83–1.14)a |
| Operative vaginal delivery | 76 (2.8) | 67 (2.7) | .74 |
| Vaginal birth after CD | 161/523 (30.8) | 140/466 (30.0) | .85 |
| Indication for cesarean deliveryb | |||
| Previa or previous transfundal uterine surgery | 24 (3.4) | 20 (3.2) | .85 |
| Malpresentation | 96 (13.7) | 79 (12.6) | |
| Desired repeat CD | 266 (38.1) | 242 (38.7) | |
| Fetal condition | 15 (2.1) | 7 (1.1) | |
| Maternal health | 11 (1.6) | 16 (2.6) | |
| Arrest of labor: latent phase | 54 (7.7) | 52 (8.3) | |
| Arrest of labor: active phase | 67 (9.6) | 59 (9.4) | |
| Arrest of labor: second stage | 57 (8.2) | 49 (7.8) | |
| NRFHT or other intrapartum emergency | 104 (14.9) | 94 (15.2) | |
| Maternal request | 5 (0.7) | 7 (1.1) | |
| 3rd- or 4th-degree perineal laceration | 111 (4.2) | 107 (4.2) | .94 |
| Preeclampsia or eclampsia | 281 (10.5) | 287 (11.4) | .35 |
| Chorioamnionitis | 213 (8.0) | 242 (9.6) | <.05 |
| QBL ≥1500 mL | 145 (5.4) | 115 (4.6) | .17 |
| Transfusion | 53 (2.0) | 69 (2.7) | .09 |
| Severe maternal morbidity excluding transfusionc | 26 (1.0) | 36 (1.4) | .17 |
| ICU admission | 3 (0.1) | 1 (0.0) | .66 |
| Neonatal | |||
| Birthweight (g) | 3370 (3080–3360) | 3340 (3050–3637) | .03 |
| APGAR score <7 at 5 min | 24 (0.9) | 26 (1.0) | .74 |
| Unexpected newborn complicationde | 67 (2.5) | 64 (2.5) | .98 |
| Unexpected newborn complication, severede | 28 (1.0) | 26 (1.0) | .95 |
Data are shown as number (percentage), number/total number (percentage), or median (interquartile range).
CD, cesarean delivery; ICU, intensive care unit; NRFHT, nonreassuring fetal heart tracing; POST, post-implementation deliveries; PRE, pre-implementation deliveries; QBL, quantitative blood loss.
Adjusted for age, prepregnancy body mass index, race and ethnicity, diabetes mellitus, previous CD, fetal presentation at delivery, and placenta previa or other absolute contraindication to vaginal delivery
Percentages refer to the subset of patients who underwent CD
Severe maternal morbidity is defined as any of 20 possible acute maternal conditions including, but not limited to, pulmonary edema, sepsis, shock, venous thromboembolism, heart failure, and others; a complete list is available in Appendix A
An unexpected newborn complication is defined as a moderate or severe neonatal complication, excluding congenital malformations, severe fetal conditions, birthweight <2500 g, or exposure to maternal drug use; a complete list is available in Appendix A
Data are not available for 1 infant in the POST period that was given up for adoption.
Jelks. Embracing 39-week elective induction. Am J Obstet Gynecol Glob Rep 2023.