The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes

Citation

Grobman, William A.; Bailit, Jennifer L.; Sandoval, Grecio; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Thorp, John M., Jr.; Caritis, Steve N.; Prasad, Mona; & Tita, Alan T. N., et al. (2018). The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes. American Journal of Perinatology, 35(3), 247-253. PMCID: PMC5801156

Abstract

Objective: The objective of this study was to estimate whether the decision-to-incision (DTI) time for cesarean delivery (CD) is associated with differences in maternal and neonatal outcomes.
Methods: This analysis is of data from women at 25 U.S. medical centers with a term, singleton, cephalic nonanomalous gestation and no prior CD, who underwent an intrapartum CD. Perinatal and maternal outcomes associated with DTI intervals of ≤ 15, 16 to 30, and > 30 minutes were compared.
Results: Among 3,482 eligible women, median DTI times were 46 and 27 minutes for arrest and fetal indications for CD, respectively (p < 0.01). Women with a fetal indication whose DTI interval was > 30 minutes had similar odds to the referent group (DTI of 16–30 minutes) for the adverse neonatal and maternal composites (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.40–1.71 and OR: 0.89, 95% CI: 0.63–1.27). For arrest disorders, the odds of the adverse neonatal composite were lower among women with a DTI of > 30 minutes (OR: 0.25, 95% CI: 0.08–0.77), and the adverse maternal composite was no different (OR: 1.15, 95% CI: 0.81–1.63).
Conclusion: In this analysis, DTI times longer than 30 minutes were not associated with worse maternal or neonatal outcomes.

URL

http://dx.doi.org/10.1055/s-0037-1606641

Reference Type

Journal Article

Year Published

2018

Journal Title

American Journal of Perinatology

Author(s)

Grobman, William A.
Bailit, Jennifer L.
Sandoval, Grecio
Reddy, Uma M.
Wapner, Ronald J.
Varner, Michael W.
Thorp, John M., Jr.
Caritis, Steve N.
Prasad, Mona
Tita, Alan T. N.
Saade, George R.
Sorokin, Yoram
Rouse, Dwight J.
Blackwell, Sean C.
Tolosa, Jorge E., for the
Eunice Kennedy Shriver
National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

PMCID

PMC5801156

ORCiD

Thorp - 0000-0002-9307-6690