Impact of maternal age on delivery outcomes following spontaneous labour at term

Omih, Edwin; Lindow, Stephen W.

doi:10.1515/jpm-2015-0128

Cited by 18 publications

(20 citation statements)

References 12 publications

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“…We also excluded women with preexisting and antepartum health conditions including diabetes, hypertension, heart disease, renal disease, gastrointestinal disease, depression, seizure disorders, thyroid disease, asthma, anemia, or HIV/herpes. Women without documented age, race, or health insurance type were excluded because those variables were considered critical potential confounders of the analyses since maternal age, 1,[16][17][18][19] race, 1,20 and health insurance type 21 are associated with variations in cesarean rates and certain labor processes. Finally, we excluded medical centers where the presence or absence of midwife practitioners could not be explicitly determined.…”

Section: Introductionmentioning

confidence: 99%

Midwifery presence in United States medical centers and labor care and birth outcomes among low‐risk nulliparous women: A Consortium on Safe Labor study

Neal

Carlson

Phillippi

et al. 2018

Birth

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Background: The presence of midwives in a health system may affect perinatal outcomes but has been inadequately described in United States settings. Our objective was to compare labor processes and outcomes for low-risk nulliparous women birthing in United States medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). Methods: We conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk nulliparous women who birthed in interprofessional (n = 7393) or noninterprofessional centers (n = 6982). Unadjusted, adjusted (age, race, health insurance type), propensity-adjusted, and propensity-matched logistic regression models were used to compare outcomes. Results: There was concordance across logistic regression models, the most restrictive and conservative of which were propensity-matched models. With this approach, women at interprofessional medical centers, compared with women at noninterprofessional centers, were 74% less likely to undergo labor induction (risk ratio [RR] 0.26; 95% CI 0.24–0.29) and 75% less likely to have oxytocin augmentation (RR 0.25; 95% CI 0.22–0.29). The cesarean birth rate was 12% lower at interprofessional centers (RR 0.88; 95% CI 0.79–0.98). Adverse neonatal outcomes occurred in only 0.3% of births and were thus too rare to be modeled. Conclusions: The care processes and birth outcomes at interprofessional and noninterprofessional medical centers differed significantly. Nulliparous women receiving care at interprofessional centers were less likely to experience induction, oxytocin augmentation, and cesarean than women at noninterprofessional centers. Labor care and birth outcome differences between interprofessional and noninterprofessional centers may be the result of the presence of midwives and interprofessional collaboration, organizational culture, or both.

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Section: Introductionmentioning

confidence: 99%

Midwifery presence in United States medical centers and labor care and birth outcomes among low‐risk nulliparous women: A Consortium on Safe Labor study

Neal

Carlson

Phillippi

et al. 2018

Birth

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“…The increasing number of studies focusing on the effects of advanced maternal age on pregnancy outcomes is a reflection of the phenomenon of postponement of childbirth in high‐ and middle‐income countries during the last two decades. These studies have reported associations between advanced maternal age and increased risk of outcomes such as stillbirth , preterm birth , anal sphincter injury , labor dystocia (LD) and operative delivery . Often, only nulliparous women are included in these studies, or nullipara and a merged group of all multipara.…”

Section: Introductionmentioning

confidence: 99%

Risk of labor dystocia increases with maternal age irrespective of parity: a population-based register study

Waldenström

Ekéus

2017

Acta Obstet Gynecol Scand

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“…). In women over 35 years of age in spontaneous labour the need for augmentation, that is, oxytocin infusion to strengthen contractions, was approximately double that of women of 20–24 years (Omih & Lindow, ) (30,000 British women) (Fig. ).…”

Section: The Need To Augment Contractions and For Caesarean Delivery mentioning

confidence: 99%

“…Data from 30,022 women in the UK, 46% primiparae and 54% multiparae. Compiled from data in Omih and Lindow ().…”

Section: The Need To Augment Contractions and For Caesarean Delivery mentioning

confidence: 99%

Mother Nature versus Father Time

Parkington

Sheehan

Coleman

et al. 2017

The Journal of Physiology

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Impact of maternal age on delivery outcomes following spontaneous labour at term

Abstract: Increasing maternal age is an independent risk factor for operative delivery, and perineal trauma. However, maternal age has no significant effect on admission of infants into the NICU during the first 24 h following delivery.

Cited by 18 publications

References 12 publications

Midwifery presence in United States medical centers and labor care and birth outcomes among low‐risk nulliparous women: A Consortium on Safe Labor study

Midwifery presence in United States medical centers and labor care and birth outcomes among low‐risk nulliparous women: A Consortium on Safe Labor study

Risk of labor dystocia increases with maternal age irrespective of parity: a population-based register study

Mother Nature versus Father Time

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