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Improved neonatal o...
Improved neonatal outcome after active management of prolonged pregnancies beyond 41+2 weeks in nulliparous, but not among multiparous women
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- Lindegren, Lina (författare)
- Helsingborg Hospital
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- Stuart, Andrea (författare)
- Helsingborg Hospital
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- Herbst, Andreas (författare)
- Helsingborg Hospital
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- Källe´n, Karin (författare)
- Lund University,Lunds universitet,Miljöepidemiologi,Forskargrupper vid Lunds universitet,Tornbladinstitutet,Environmental Epidemiology,Lund University Research Groups,Tornblad Institute
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(creator_code:org_t)
- 2017-11-01
- 2017
- Engelska.
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349. ; 96:12, s. 1467-1474
- Relaterad länk:
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http://dx.doi.org/10...
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https://obgyn.online...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Introduction: Prolonged pregnancies are associated with adverse maternal and fetal outcome. In Sweden, no national guidelines exist for when to induce prolonged pregnancies. Material and methods: Singleton cephalic prolonged pregnancies (defined as ≥ 41+3 gestational weeks) during 2001-2013 (n = 199 770) were identified using the Swedish Medical Birth Register. The maternity units were divided into three groups (tertiles) based on the proportion of pregnancies ≥ 42+3 gestational weeks among all pregnancies ≥ 41+3 weeks. The pregnancy outcome among women delivered at the units with the most expectant management of prolonged pregnancies (> 17.6% proceeding to 42+3 weeks), was compared with that among women delivered at units with the most active management (< 12.6% proceeding to 42+3 weeks). Odds ratios (OR) were calculated using simple and multiple logistic regression. Adjustments were made for year of delivery, hospital level, maternal age, body mass index, and smoking. Results: Among primiparas, an increased risk of Apgar score < 7 at 5 minutes [odds ratio (OR) 1.27, 95% CI 1.16-1.41] and meconium aspiration (OR 1.49, 95% CI 1.14-1.95) was found after birth at most expectant units compared with most active units, but among multiparas, no such associations were detected. A decreased rate of cesarean section was found for both primiparas (OR 0.83, 95% CI 0.80-0.86) and multiparas (OR 0.82, 95% CI 0.77-0.86) at units with expectant versus active management. No association between perinatal death and delivery-unit specific management of prolonged pregnancies was detected. Conclusions: Offspring to primiparas might gain from a more active management of prolonged pregnancies, whereas no such improvement of neonatal outcome among multiparous women was detected.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Fetal outcome
- Parity
- Post-term pregnancy
- Practical management
- Prolonged pregnancy
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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