Table 1:
Baseline characteristics of the cohort
| Vaginal Delivery (n=1214) | Intrapartum Cesarean Delivery (n=564) | Not Labored Cesarean Delivery (n=1143) | Intended VD (VD + Intrapartum CD) (n=1778) | All CD (Intrapartum + Not Labored CD) (n=1707) | p-value Intended VD vs. Not labored CD (Intention to treat) | p-value actual VD vs. intrapartum+ non labored CD (As-treated) | |
|---|---|---|---|---|---|---|---|
| Demographic Characteristics | |||||||
| Age, years (median, [Q1, Q3]) | 30 [25, 35] | 31 [26, 35] | 32 [28, 36] | 30 [26, 35] | 31 [27, 36] | <0.001 | <0.001 |
| Primary Payor | 0.020 | 0.043 | |||||
| Managed care | 341 (28.1%) | 182 (32.3%) | 309 (27.0%) | 523 (29.4%) | 491 (28.8%) | ||
| Medicaid | 668 (55.0%) | 288 (51.1%) | 617 (54.0%) | 956 (53.8%) | 905 (53.0%) | ||
| Medicare | 35 (2.9%) | 22 (3.9%) | 62 (5.4%) | 57 (3.2%) | 84 (4.9%) | ||
| Other | 170 (14.0%) | 72 (12.8%) | 155 (13.6%) | 242 (13.6%) | 227 (13.3%) | ||
| Race | 0.592 | 0.003 | |||||
| Asian | 43 (3.5%) | 17 (3.0%) | 33 (2.9%) | 60 (3.4%) | 50 (2.9%) | ||
| Black | 338 (27.8%) | 191 (33.9%) | 355 (31.1%) | 529 (29.8%) | 546 (32.0%) | ||
| Other | 127 (10.5%) | 70 (12.4%) | 111 (9.7%) | 197 (11.1%) | 181 (10.6%) | ||
| Unknown | 33 (2.7%) | 31 (5.5%) | 48 (4.2%) | 64 (3.6%) | 79 (4.6%) | ||
| White | 673 (55.4%) | 255 (45.2%) | 596 (52.1%) | 928 (52.2%) | 851 (49.9%) | ||
| Ethnicity | 0.282 | 0.023 | |||||
| Hispanic | 118 (9.7%) | 69 (12.2%) | 142 (12.4%) | 187 (10.5%) | 211 (12.4%) | ||
| Non-Hispanic | 873 (71.9%) | 370 (65.6%) | 782 (68.4%) | 1243 (69.9%) | 1152 (67.5%) | ||
| Unknown | 223 (18.4%) | 125 (22.2%) | 219 (19.2%) | 348 (19.6%) | 344 (20.2%) | ||
| Hospital Characteristics | |||||||
| Urban hospital | 1096 (90.3%) | 534 (94.7%) | 1059 (92.7%) | 1630 (91.7%) | 1593 (93.3%) | 0.342 | 0.003 |
| Teaching hospital | 815 (67.1%) | 391 (69.3%) | 724 (63.3%) | 1206 (67.8%) | 1115 (65.3%) | 0.012 | 0.307 |
| Bed size | 0.145 | 0.030 | |||||
| 000–099 | 38 (3.1%) | 7 (1.2%) | 26 (2.3%) | 45 (2.5%) | 33 (1.9%) | ||
| 100–199 | 78 (6.4%) | 38 (6.7%) | 65 (5.7%) | 116 (6.5%) | 103 (6.0%) | ||
| 200–299 | 142 (11.7%) | 58 (10.3%) | 116 (10.1%) | 200 (11.2%) | 174 (10.2%) | ||
| 300–399 | 177 (14.6%) | 78 (13.8%) | 177 (15.5%) | 255 (14.3%) | 255 (14.9%) | ||
| 400–499 | 184 (15.2%) | 80 (14.2%) | 138 (12.1%) | 264 (14.8%) | 218 (12.8%) | ||
| 500+ | 595 (49.0%) | 303 (53.7%) | 621 (54.3%) | 898 (50.5%) | 924 (54.1%) | ||
| Region of country | 0.125 | 0.022 | |||||
| Midwest | 322 (26.5%) | 133 (23.6%) | 259 (22.7%) | 455 (25.6%) | 392 (23.0%) | ||
| Northeast | 156 (12.9%) | 93 (16.5%) | 161 (14.1%) | 249 (14.0%) | 254 (14.9%) | ||
| South | 508 (41.8%) | 245 (43.4%) | 531 (46.5%) | 753 (42.4%) | 776 (45.5%) | ||
| West | 228 (18.8%) | 93 (16.5%) | 192 (16.8%) | 321 (18.1%) | 285 (16.7%) | ||
| Operative vaginal delivery | 125 (10.3%) | N/A | N/A | 125 (7.0%) | N/A | N/A | N/A |
| Comorbidities | |||||||
| Gestational Diabetes | 92 (7.6%) | 59 (10.5%) | 144 (12.6%) | 151 (8.5%) | 203 (11.9%) | <0.001 | <0.001 |
| HIV/AIDS | 1 (0.1%) | 1 (0.2%) | 9 (0.8%) | 2 (0.1%) | 10 (0.6%) | 0.004 | 0.029 |
| Preexisting Diabetes | 60 (4.9%) | 69 (12.2%) | 126 (11.0%) | 129 (7.3%) | 195 (11.4%) | <0.001 | <0.001 |
| Prior cesarean birth | 61 (5.0%) | 128 (22.7%) | 611 (53.5%) | 189 (10.6%) | 739 (43.3%) | <0.001 | <0.001 |
| Multiple gestation | 15 (1.2%) | 13 (2.3%) | 71 (6.2%) | 28 (1.6%) | 84 (4.9%) | <0.001 | <0.001 |
| Asthma | 217 (17.9%) | 140 (24.8%) | 256 (22.4%) | 357 (20.1%) | 396 (23.2%) | 0.133 | 0.001 |
| Bleeding disorder | 60 (4.9%) | 33 (5.9%) | 60 (5.2%) | 93 (5.2%) | 93 (5.4%) | 0.982 | 0.545 |
| BMI ≥ 40 kg/m2 | 84 (6.9%) | 67 (11.9%) | 137 (12.0%) | 151 (8.5%) | 204 (12.0%) | 0.002 | <0.001 |
| Chronic hypertension | 247 (20.3%) | 169 (30.0%) | 369 (32.3%) | 416 (23.4%) | 538 (31.5%) | <0.001 | <0.001 |
| Secondary hypertension | 1 (0.1%) | 0 (0.0%) | 1 (0.1%) | 1 (0.1%) | 1 (0.1%) | 0.753 | 0.809 |
| Hypertensive crisis | 8 (0.7%) | 7 (1.2%) | 30 (2.6%) | 15 (0.8%) | 37 (2.2%) | 0.000 | 0.001 |
| Chronic renal disease | 34 (2.8%) | 41 (7.3%) | 62 (5.4%) | 75 (4.2%) | 103 (6.0%) | 0.132 | <0.001 |
| Connective tissue or autoimmune disease | 20 (1.6%) | 9 (1.6%) | 19 (1.7%) | 29 (1.6%) | 28 (1.6%) | 0.948 | 0.988 |
| Substance use disorder | 229 (18.9%) | 92 (16.3%) | 198 (17.3%) | 321 (18.1%) | 290 (17.0%) | 0.614 | 0.192 |
| Advanced maternal age | 257 (21.2%) | 129 (22.9%) | 314 (27.5%) | 386 (21.7%) | 443 (26.0%) | <0.001 | 0.003 |
| Preexisting anemia | 247 (20.3%) | 142 (25.2%) | 285 (24.9%) | 389 (21.9%) | 427 (25.0%) | 0.056 | 0.003 |
| Bariatric surgery | 10 (0.8%) | 11 (2.0%) | 19 (1.7%) | 21 (1.2%) | 30 (1.8%) | 0.275 | 0.032 |
| Gastrointestinal disease | 126 (10.4%) | 83 (14.7%) | 177 (15.5%) | 209 (11.8%) | 260 (15.2%) | 0.004 | 0.000 |
| Mental health disorder | 227 (18.7%) | 119 (21.1%) | 239 (20.9%) | 346 (19.5%) | 358 (21.0%) | 0.339 | 0.130 |
| Neuromuscular disease | 91 (7.5%) | 57 (10.1%) | 102 (8.9%) | 148 (8.3%) | 159 (9.3%) | 0.572 | 0.083 |
| Placental abruption | 25 (2.1%) | 30 (5.3%) | 24 (2.1%) | 55 (3.1%) | 54 (3.2%) | 0.106 | 0.070 |
| Placenta accreta spectrum | 2 (0.2%) | 3 (0.5%) | 7 (0.6%) | 5 (0.3%) | 10 (0.6%) | 0.172 | 0.080 |
| Preeclampsia/gestational hypertension | 217 (17.9%) | 150 (26.6%) | 276 (24.1%) | 367 (20.6%) | 426 (25.0%) | 0.026 | <0.001 |
| Preeclampsia with severe features/HELLP | 93 (7.7%) | 116 (20.6%) | 199 (17.4%) | 209 (11.8%) | 315 (18.5%) | <0.001 | <0.001 |
| Preterm delivery | 302 (24.9%) | 291 (51.6%) | 566 (49.5%) | 593 (33.4%) | 857 (50.2%) | <0.001 | <0.001 |
| Thyrotoxicosis | 17 (1.4%) | 8 (1.4%) | 19 (1.7%) | 25 (1.4%) | 27 (1.6%) | 0.579 | 0.692 |
| Congenital heart disease | 45 (3.7%) | 11 (2.0%) | 38 (3.3%) | 56 (3.1%) | 49 (2.9%) | 0.794 | 0.207 |
| Valvular heart disease | 140 (11.5%) | 67 (11.9%) | 160 (14.0%) | 207 (11.6%) | 227 (13.3%) | 0.061 | 0.156 |
| Pulmonary hypertension | 31 (2.6%) | 18 (3.2%) | 64 (5.6%) | 49 (2.8%) | 82 (4.8%) | <0.001 | 0.002 |
| Eisenmenger syndrome | 1 (0.1%) | 0 (0.0%) | 0 (0.0%) | 1 (0.1%) | 0 (0.0%) | 0.423 | 0.236 |
| Arrythmias | 210 (17.3%) | 65 (11.5%) | 202 (17.7%) | 275 (15.5%) | 267 (15.6%) | 0.116 | 0.233 |
| Aortopathies | 5 (0.4%) | 5 (0.9%) | 6 (0.5%) | 10 (0.6%) | 11 (0.6%) | 0.893 | 0.401 |
| Coronary artery/ischemic/atherosclerotic | 68 (5.6%) | 40 (7.1%) | 76 (6.6%) | 108 (6.1%) | 116 (6.8%) | 0.533 | 0.190 |
| Other cardiac disease | 27 (2.2%) | 21 (3.7%) | 31 (2.7%) | 48 (2.7%) | 52 (3.0%) | 0.984 | 0.177 |