Observational studyObstetrics and gynecology2020
Neonatal and Maternal Composite Adverse Outcomes Among Low-Risk Nulliparous Women Compared With Multiparous Women at 39-41 Weeks of Gestation.
Observational study in Obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis.Reproduction & fertility · 2023Pooled it
- Evaluating a Group-Based Intervention Addressing Fear of Childbirth in Multiparous Pregnant Women: A Mixed Methods Feasibility Study.Journal of advanced nursing · 2026Article
- Adverse perinatal outcomes associated with macrosomia in nulliparous women: A multicenter cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Associations of CRP and PCT levels with obstetric and neonatal outcomes: a prospective study.BMC pregnancy and childbirth · 2025Article
- Safety of a trial of labor after cesarean in kidney and liver transplant recipients: A multicenter cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Neonatal and maternal morbidity rates in low-risk nulliparous women across different gestational ages.iScience · 2025Article
- Risk factors for neonatal admission from the beginning of pregnancy in Northeast Spain.Journal of paediatrics and child health · 2025Observational
- Gestational diabetes mellitus in previous pregnancy associated with the risk of large for gestational age and macrosomia in the second pregnancy.Frontiers in endocrinology · 2025Article
- Neonatal and maternal adverse outcomes among low-risk nulliparous women compared with multiparous women at 37-41 weeks of gestation: a cohort study in South China.Frontiers in medicine · 2025Article
- Unintended Pregnancy After Kidney Transplantation: Risk Factors and Associated Obstetric and Allograft Outcomes.O&G open · 2024Article
- Reproductive Tract Microbial Transitions from Late Gestation to Early Postpartum Using 16S rRNA Metagenetic Profiling in First-Pregnancy Heifers.International journal of molecular sciences · 2024Article
- Article
- Trajectory of gestational weight gain is related to birthweight: The TAWS cohort study in China.Maternal & child nutrition · 2024Article
- Article
- Dose-response associations of maternal age with pregnancy complications and multimorbidity among nulliparas and multiparas: A multicentric retrospective cohort study in southern China.Journal of global health · 2023Article
- Parity and gestational age are associated with vaginal microbiota composition in term and late term pregnancies.EBioMedicine · 2022Article
- Term Neonatal Complications During the Second Localized COVID-19 Lockdown and Prolonged Premature Rupture of Membranes at Home Among Nulliparas With Reference Interval for Maternal C-Reactive Protein: A Retrospective Cohort Study.Frontiers in pediatrics · 2022Article
- Incidence of Infertility and Pregnancy Complications in US Female Surgeons.JAMA surgery · 2021Article
- Mode of Obstetric Delivery in Kidney and Liver Transplant Recipients and Associated Maternal, Neonatal, and Graft Morbidity During 5 Decades of Clinical Practice.JAMA network open · 2021Article
- Contribution of Maternal Age to Increasing Severe Maternal Morbidity During Birth and Up to 1 Year Postpartum.Women's health issues : official publication of the Jacobs Institute of Women's HealthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo estimate whether the frequency of adverse maternal and neonatal outcomes differs between low-risk nulliparous and multiparous women at 39-41 weeks of gestation.
methodsThis is a secondary analysis of an observational obstetrics cohort of maternal-neonatal dyads at 25 hospitals. Low-risk women with nonanomalous singletons who delivered between 39 0/7 and 41 6/7 weeks of gestation were included. The composite neonatal adverse outcome included 5-minute Apgar score less than five, ventilator support or cardiopulmonary resuscitation, seizure, hypoxic ischemic encephalopathy, sepsis, bronchopulmonary dysplasia, persistent pulmonary hypertension, necrotizing enterocolitis, birth injury or perinatal death. The composite maternal adverse outcome included infection, third- or fourth-degree perineal laceration, thromboembolism, transfusion of blood products, or maternal death. Small for gestational age (SGA), large for gestational age (LGA), and shoulder dystocia requiring maneuvers were also evaluated. Multivariable regression was used to estimate adjusted relative risks (aRRs) and adjusted odds ratios (aORs) with 95% CIs.
resultsOf the 115,502 women in the overall cohort, 39,870 (34.5%) met eligibility criteria for this analysis; 18,245 (45.8%) were nulliparous. The risk of the composite neonatal adverse outcome (1.5% vs 1.0%, aRR 1.80, 95% CI 1.48-2.19), composite maternal adverse outcome (15.1% vs 3.3%, aRR 5.04, 95% CI 4.62-5.49), and SGA (8.9% vs 5.8%, aOR 1.45, 95% CI 1.33-1.57) was significantly higher in nulliparous than multiparous patients. The risk of LGA (aOR 0.65, 95% CI 0.60-0.71) and shoulder dystocia with maneuvers (aRR 0.68, 95% CI 0.60-0.77) was significantly lower in nulliparous rather than multiparous patients.
conclusionThe risk of composite adverse outcomes and SGA among low-risk nulliparous women at 39-41 weeks of gestation is significantly higher than among multiparous counterparts. However, nulliparous women had a lower risk of shoulder dystocia with maneuvers and LGA.
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