The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes

Grobman, William A.; Bailit, Jennifer L.; Sandoval, Grecio; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M., Jr.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T. N.; Saade, George R.; Sorokin, Yoram; Rouse, Dwight J.; Blackwell, Sean C.; & Tolosa, Jorge E., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network. (Forthcoming). The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes. American Journal of Perinatology.

Grobman, William A.; Bailit, Jennifer L.; Sandoval, Grecio; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M., Jr.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T. N.; Saade, George R.; Sorokin, Yoram; Rouse, Dwight J.; Blackwell, Sean C.; & Tolosa, Jorge E., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network. (Forthcoming). The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes. American Journal of Perinatology.

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Objective: The objective of this study was to estimate whether the decision-to-incision (DTI) time for cesarean delivery (CD) is associated with differences in maternal and neonatal outcomes. Methods: This analysis is of data from women at 25 U.S. medical centers with a term, singleton, cephalic nonanomalous gestation and no prior CD, who underwent an intrapartum CD. Perinatal and maternal outcomes associated with DTI intervals of ≤ 15, 16 to 30, and > 30 minutes were compared. Results: Among 3,482 eligible women, median DTI times were 46 and 27 minutes for arrest and fetal indications for CD, respectively (p < 0.01). Women with a fetal indication whose DTI interval was > 30 minutes had similar odds to the referent group (DTI of 16–30 minutes) for the adverse neonatal and maternal composites (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.40–1.71 and OR: 0.89, 95% CI: 0.63–1.27). For arrest disorders, the odds of the adverse neonatal composite were lower among women with a DTI of > 30 minutes (OR: 0.25, 95% CI: 0.08–0.77), and the adverse maternal composite was no different (OR: 1.15, 95% CI: 0.81–1.63). Conclusion: In this analysis, DTI times longer than 30 minutes were not associated with worse maternal or neonatal outcomes.




JOUR



Grobman, William A.
Bailit, Jennifer L.
Sandoval, Grecio
Reddy, Uma M.
Wapner, Ronald J.
Varner, Michael W.
Thorp, John M., Jr.
Caritis, Steve N.
Prasad, Mona
Tita, Alan T. N.
Saade, George R.
Sorokin, Yoram
Rouse, Dwight J.
Blackwell, Sean C.
Tolosa, Jorge E., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network



Forthcoming


American Journal of Perinatology













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