ArticleO&G open2026
Association of Intended Mode of Delivery With Neonatal and Maternal Outcomes at 22-25 Weeks of Gestation.
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Authors and funding
18 authors.
Jameaka L HamiltonDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Paula L McGeeDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Baha M SibaiDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Michael W VarnerDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Alan T N TitaDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Monica LongoDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Edward F BellDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Barbara J StollDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
John M ThorpDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Uma M ReddyDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Heather A FreyDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Emily S MillerDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Dwight J RouseDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Hyagriv N SimhanDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Jennifer L BailitDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Lorraine DugoffDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
George R SaadeDepartment of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; The George Washington University Biostatistics Center, Washington, DC; University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; University of Utah Health Sciences Center, Salt Lake City, Utah; Alabama at Birmingham, Birmingham, Alabama; Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; University of Iowa, Iowa City, Iowa; Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Columbia University, New York, New York; Department of Obstetrics and Gynecology at The Ohio State University, Columbus, Ohio; Northwestern University, Chicago, Illinois; Brown University, Providence, Rhode Island; University of Pittsburgh, Pittsburgh, Pennsylvania; Case Western Reserve University, Cleveland, Ohio; University of Pennsylvania, Philadelphia, Pennsylvania; and University of Texas Medical Branch, Galveston, Texas.
Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Funding
SARS-CoV-2 Vaccine Pregnancy RegistryU24HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI Rebecca Gersnoviez Clifton · 2021 to 2026
$39.2MMaternal-Fetal Medicine Units (MFMU) NetworkUG1HD040485 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Noelia Milena Modad Zork · 2016 to 2026
$3.6MNICHD Maternal Fetal Medicine Units NetworkUG1HD087192 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI Lorraine Dugoff · 2016 to 2026
$3.6MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD040544 · NICHD · CASE WESTERN RESERVE UNIVERSITY · PI Kelly S Gibson, Angela C. Ranzini · 2016 to 2026
$3.5MMaternal-Fetal Medicine Units Network -- The Northwestern Study CenterUG1HD040512 · NICHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Lynn M Yee · 2016 to 2026
$3.4MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD040500 · NICHD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI DWIGHT J ROUSE · 2016 to 2026
$3.4MUofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical CentersUG1HD034208 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Torri D Metz · 2016 to 2026
$3.4MNICHD Maternal Fetal Medicine Units NetworkUG1HD027915 · NICHD · OHIO STATE UNIVERSITY · PI Maged Costantine · 2016 to 2026
$3.3MUNC MFMU: Advancing Perinatal Health via Definitive, Multi-Site Clinical StudiesUG1HD040560 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI John M Thorp · 2016 to 2026
$3.3MNICHD Cooperative Multicenter Neonatal Research NetworkUG1HD053109 · NICHD · UNIVERSITY OF IOWA · PI Tarah Trinity Colaizy · 2016 to 2026
$3.2MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD087230 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HYAGRIV N SIMHAN · 2016 to 2026
$3.2MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD040545 · NICHD · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI Hector Mendez-Figueroa · 2016 to 2026
$3.2MNICHD NIH HHS U24 HD036801NICHD NIH HHS UG1 HD027851NICHD NIH HHS UG1 HD027869NICHD NIH HHS UG1 HD027915NICHD NIH HHS UG1 HD034208NICHD NIH HHS UG1 HD040485NICHD NIH HHS UG1 HD040500NICHD NIH HHS UG1 HD040512NICHD NIH HHS UG1 HD040544NICHD NIH HHS UG1 HD040545NICHD NIH HHS UG1 HD040560NICHD NIH HHS UG1 HD053097NICHD NIH HHS UG1 HD053109NICHD NIH HHS UG1 HD087192NICHD NIH HHS UG1 HD087230
Abstract
objectiveTo compare the risk of neonatal and maternal morbidity and mortality among individuals who delivered between 22 and 25 weeks of gestation by intended mode of delivery.
methodsThis was a secondary analysis of an observational cohort including participants with a singleton pregnancy delivered by planned cesarean delivery or after a trial of labor from 22 0/7 to 25 6/7 weeks of gestation. This analysis was limited to those who received both antenatal steroids and neonatal resuscitation. The primary outcome was a composite of neonatal death or severe neonatal morbidity. Secondary outcomes included neonatal mortality and measures of neonatal and maternal morbidity. Multivariable logistic regression analyses were used to adjust for prespecified covariates.
resultsAmong 277 eligible individuals, 149 (53.8%) had a planned cesarean delivery, and 128 (46.2%) had a trial of labor, of whom 12 (9.4%) delivered by cesarean. The two groups were similar except for more frequent hypertensive disorders (47.7% vs 26.6%,
conclusionIn this multisite registry, there was no difference in composite neonatal mortality or severe morbidity based on the intended mode of delivery, as well as no difference in secondary neonatal outcomes. Planned cesarean delivery was associated with increased maternal morbidity.
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