Significant effects on neonatal morbidity and mortality after regional change in management of post-term pregnancy.
(2011) In Acta Obstetricia et Gynecologica Scandinavica 90(1). p.26-32- Abstract
- Objective. To evaluate the effects on neonatal morbidity of a regional change in induction policy for post-term pregnancy from 43(+0) to 42(+0) gestational weeks (GWs). Design and setting. Nationwide retrospective register study between 2000 and 2007. Population. All singleton pregnancies with a gestational age of >41(+2) GW (n= 119,198). Methods. All Swedish counties were divided into three groups where study group allocation was designated by the proportion of pregnancies >42(+2) GW among all pregnancies of >41(+2) GW. Stockholm county formed a separate group. Main outcome measures. Perinatal morbidity. Results. In counties with the most active management, 19% of pregnancies >41(+2) GW were delivered at >42(+2) GW during... (More)
- Objective. To evaluate the effects on neonatal morbidity of a regional change in induction policy for post-term pregnancy from 43(+0) to 42(+0) gestational weeks (GWs). Design and setting. Nationwide retrospective register study between 2000 and 2007. Population. All singleton pregnancies with a gestational age of >41(+2) GW (n= 119,198). Methods. All Swedish counties were divided into three groups where study group allocation was designated by the proportion of pregnancies >42(+2) GW among all pregnancies of >41(+2) GW. Stockholm county formed a separate group. Main outcome measures. Perinatal morbidity. Results. In counties with the most active management, 19% of pregnancies >41(+2) GW were delivered at >42(+2) GW during 2000-2004 compared to 7.1% in 2005-2007. In the least active counties, corresponding figures were 21.0% compared to 19.4%. During 2005-2007, the odds ratios for meconium aspiration and 5-minute Apgar score of ≤6 in the least compared to most active counties, were 1.55 (95% CI: 1.03-2.33) and 1.26 (95% CI: 1.06-1.51). In Stockholm >42(+2) GW seen among pregnancies of >41(+2) decreased from 21.0% in 2000-2004 to 5.9% in 2005-2007. Reduced perinatal death risks by 48%, meconium aspiration of 51% and low Apgar scores by 31% in 2005-2007 compared with 2000-2004 were observed. Rates of operative deliveries at >41(+2) GW in Stockholm were unaltered. Conclusion. A significant reduction in perinatal morbidity was found, with no influence on operative delivery rates for post-term pregnancy in Stockholm. We advocate a nationwide change toward more active management of post-term pregnancies. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1832613
- author
- Grunewald, Charlotta ; Håkansson, Stellan ; Saltvedt, Sissel and Källén, Karin LU
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Obstetricia et Gynecologica Scandinavica
- volume
- 90
- issue
- 1
- pages
- 26 - 32
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000287103300005
- pmid:21275912
- scopus:79951482216
- ISSN
- 1600-0412
- DOI
- 10.1111/j.1600-0412.2010.01019.x
- language
- English
- LU publication?
- yes
- id
- 03add285-ef89-4801-92f4-7ec96d107108 (old id 1832613)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/21275912?dopt=Abstract
- date added to LUP
- 2016-04-04 09:41:54
- date last changed
- 2022-01-29 19:10:21
@article{03add285-ef89-4801-92f4-7ec96d107108,
abstract = {{Objective. To evaluate the effects on neonatal morbidity of a regional change in induction policy for post-term pregnancy from 43(+0) to 42(+0) gestational weeks (GWs). Design and setting. Nationwide retrospective register study between 2000 and 2007. Population. All singleton pregnancies with a gestational age of >41(+2) GW (n= 119,198). Methods. All Swedish counties were divided into three groups where study group allocation was designated by the proportion of pregnancies >42(+2) GW among all pregnancies of >41(+2) GW. Stockholm county formed a separate group. Main outcome measures. Perinatal morbidity. Results. In counties with the most active management, 19% of pregnancies >41(+2) GW were delivered at >42(+2) GW during 2000-2004 compared to 7.1% in 2005-2007. In the least active counties, corresponding figures were 21.0% compared to 19.4%. During 2005-2007, the odds ratios for meconium aspiration and 5-minute Apgar score of ≤6 in the least compared to most active counties, were 1.55 (95% CI: 1.03-2.33) and 1.26 (95% CI: 1.06-1.51). In Stockholm >42(+2) GW seen among pregnancies of >41(+2) decreased from 21.0% in 2000-2004 to 5.9% in 2005-2007. Reduced perinatal death risks by 48%, meconium aspiration of 51% and low Apgar scores by 31% in 2005-2007 compared with 2000-2004 were observed. Rates of operative deliveries at >41(+2) GW in Stockholm were unaltered. Conclusion. A significant reduction in perinatal morbidity was found, with no influence on operative delivery rates for post-term pregnancy in Stockholm. We advocate a nationwide change toward more active management of post-term pregnancies.}},
author = {{Grunewald, Charlotta and Håkansson, Stellan and Saltvedt, Sissel and Källén, Karin}},
issn = {{1600-0412}},
language = {{eng}},
number = {{1}},
pages = {{26--32}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Obstetricia et Gynecologica Scandinavica}},
title = {{Significant effects on neonatal morbidity and mortality after regional change in management of post-term pregnancy.}},
url = {{http://dx.doi.org/10.1111/j.1600-0412.2010.01019.x}},
doi = {{10.1111/j.1600-0412.2010.01019.x}},
volume = {{90}},
year = {{2011}},
}