Association of Labor With Neonatal Respiratory Outcomes at 36–40 Weeks of Gestation
Year: 2019
Type: article
Abstract: OBJECTIVE: To evaluate whether labor is associated with lower odds of respiratory morbidity among neonates born from 36 to 40 weeks of gestation and to assess whether this association varies by gestational age and maternal diabetic status. METHODS: We conducted a secondary analysis of women in the Assessment of Perinatal Excellence obstetric cohort who delivered across 25 U.S. hospitals over a 3-year period. Women with a singleton liveborn nonanomalous neonate who delivered from 36 to 40 weeks of gestation were included in our analysis. Those who received antenatal corticosteroids, underwent amniocentesis for fetal lung maturity, or did not meet dating criteria were excluded. Our primary outcome was composite neonatal respiratory morbidity, which included respiratory distress syndrome, ventilator support, continuous positive airway pressure, or neonatal death. Maternal characteristics and neonatal outcomes between women who labored and those who did not were compared. Multivariable logistic regression models were used to evaluate the association between labor and the primary outcome. Interactions between labor and diabetes mellitus and labor and gestational age were tested. RESULTS: Our analysis included 63,187 women who underwent labor and 10,629 who did not. There was no interaction between labor and diabetes mellitus (P=.90). However, there was a significant interaction between labor and gestational age (P=.01). In the adjusted model, labor was associated with lower odds of neonatal respiratory morbidity compared with no labor for neonates delivered from 36-39 weeks of gestation. A 1-week increase in gestational age was associated with a 1.2 times increase in the adjusted odds ratio for the neonatal outcome comparing labor and no labor. CONCLUSION: Labor was associated with lower odds of the composite outcome among neonates delivered from 36-39 weeks of gestation. The magnitude of this association varied by gestational age. The association was similar for women with or without diabetes mellitus.
Source: Obstetrics and Gynecology
Institutions: University of North Carolina at Chapel Hill, University of Pittsburgh, University of Utah, Brown University, University of Alabama at Birmingham, The Ohio State University, Columbia University, National Institutes of Health, George Washington University, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Case Western Reserve University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Center for Clinical and Translational Sciences (CCTS), Maternal Fetal Medicine Network: Data Coordinating Cent*, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network, Case Western Reserve University/Cleveland Clinic CTSA (UL1), NICHD Maternal Fetal Medicine Units Network, NICHD Maternal-Fetal Medicine Units (MFMU) Network, Maternal-Fetal Medicine Units Network, NICHD Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Cooperative Multicenter Maternal Fetal Medicine Units Networks, University of Utah Center for Clinical and Translational Science-UL1, Co-Operative Multicenter Trials in Obstetrics & Maternal Fetal Medicine, Data Coord Ctr-NICHD Cooperative Multicenter Maternal Medicine Units Research Net, Multicenter Network of Maternal Fetal Medicine Units, Maternal Fetal Medicine Units Network, Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network (U10), Brown/WIH Eunice Kennedy Shriver NICHD MFM Units Network Site, Maternal Fetal Medicine Network, NICHD Maternal Fetal Medicine Units Network, NICHD Materal Fetal Medicine Units Network, Clinical and Translational Science Collaborative of Cleveland, UofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical Centers, NICHD Maternal-Fetal Medicine Units (MFMU) Network: Data CoordinatingCenter, Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network, Maternal Fetal Medicine Units Network - Northwestern Study Center, Maternal-Fetal Medicine Units (MFMU) Network, Yale Clinical and Translational Science Award, Case Western Reserve University Center of the NICHD MFMU Network, Columbia University Maternal-Fetal Medicine Units Network Clinical Center, NICHD maternal fetal medicine units network, UNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical Studies, Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units (MFMU) Network (UG1)
OpenAlex ID: W2968364489