Management of pregnancy at and beyond 41 completed weeks of gestation in low-risk women: a secondary analysis of two WHO multi-country surveys on maternal and newborn health

Mya, Kyaw Swa; Laopaiboon, Malinee; Vogel, Joshua P.; Cecatti, Jose Guilherme; Souza, João Paulo; Gulmezoglu, Ahmet Metin; Ortiz-Panozo, Eduardo; Mittal, Suneeta; Lumbiganon, Pisake

doi:10.1186/s12978-017-0394-2

Reproductive Health

Table 5 Adverse maternal and perinatal outcomes among different management groups in combined databases (Sensitivity analysis)

From: Management of pregnancy at and beyond 41 completed weeks of gestation in low-risk women: a secondary analysis of two WHO multi-country surveys on maternal and newborn health

	Combined
	n/N (%)	Crude OR^a (95% CI)	AOR^b (95% CI)
Adverse maternal outcomes
PPH
IOL	168/5549 (3.03)	1.0	1.0
ECS	45/2493 (1.81)	0.98 (0.69, 1.40)	0.90 (0.61, 1.33)
EM	658/24,961 (2.64)	0.87 (0.71, 1.06)	0.88 (0.70, 1.11)
Ruptured uterus
IOL	5/5549 (0.14)	1.0	1.0
ECS	2/2493 (0.08)	0.42 (0.09, 1.79)	0.21 (0.04, 1.06)
EM	48/24,961 (0.31)	2.72 (1.18, 6.25)	1.25 (0.45, 3.45)
Admission to ICU
IOL	32/5549 (0.58)	1.0	1.0
ECS	9/2493 (0.36)	2.06 (1.01, 4.21)	1.56 (0.65, 3.76)
EM	254/24,961 (1.02)	0.78 (0.52, 1.15)	0.72 (0.45, 1.14)
Postpartum stay > 7
IOL	154/5549 (2.78)	1.0	1.0
ECS	101/2493 (4.05)	2.48 (1.87, 3.29)	1.59 (1.17, 2.18)
EM	732/24,961 (2.93)	0.97 (0.79, 1.18)	0.92 (0.74, 1.15)
Severe maternal outcome
IOL	79/5549 (1.42)	1.0	1.0
ECS	24/2493 (0.96)	1.50 (0.94, 2.40)	1.18 (0.71, 1.96)
EM	370/24,961 (1.48)	0.72 (0.54, 0.94)	0.73 (0.55, 0.99)
CS rate
IOL	1591/5549 (28.67)	1.0	1.0
EM	6026/24,961 (24.14)	0.70 (0.65, 0.75)	0.65 (0.59, 0.70)
Adverse perinatal outcomes
APGAR <7 at 5 min
IOL	109/5549 (1.97)	1.0	1.0
ECS	29/2493 (1.17)	0.86 (0.56, 1.30)	0.67 (0.41, 1.08)
EM	482/24,961 (1.94)	0.88 (0.70, 1.10)	0.97 (0.76, 1.24)
Admission to NICU
IOL	344/5549 (6.22)	1.0	1.0
ECS	257/2493 (10.31)	1.89 (1.57, 2.29)	1.54 (1.25, 1.90)
EM	1452/24,961 (5.83)	0.82 (0.72, 0.94)	0.84 (0.72, 0.97)
Stillbirth
IOL	25/5549 (0.45)	1.0	1.0
ECS	7/2493 (0.28)	0.91 (0.40, 2.08)	0.76 (0.30, 1.91)
EM	110/24,961 (0.44)	0.94 (0.60, 1.48)	1.01 (0.62, 1.65)
Early neonatal death
IOL	23/5549 (0.42)	1.0	1.0
ECS	7/2493 (0.28)	0.91 (0.39, 2.08)	0.71 (0.30, 1.68)
EM	101/24,961 (0.41)	0.93 (0.59, 1.48)	0.82 (0.51, 1.32)
Perinatal death
IOL	48/5549 (0.87)	1.0	1.0
ECS	14/2493 (0.56)	0.93 (0.51, 1.69)	0.75 (0.39, 1.43)
EM	210/24,961 (0.84)	0.92 (0.66, 1.27)	0.90 (0.63, 1.27)

IOL Induction of labour group, ECS Elective Caesarean section group, EM Expectant management group
^aCrude ORs were calculated by multilevel logistic regression model after accounted for cluster effect(facility level, country level, data source -WHOGS & WHOMCS)
^bAdjusted for maternal characteristics (age, marital status, education, parity, previous CS); neonatal characteristics (birth weight); facility capacity index score and cluster effect (facility level, country level, data source – WHOGS & WHOMCS)

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ISSN: 1742-4755

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