M. Luckas et al., Comparison of outcomes in uncomplicated term and post-term pregnancy following spontaneous labor, J PERIN MED, 26(6), 1998, pp. 475-479
This study was designed to compare outcomes of spontaneous labor in uncompl
icated term and post-term pregnancy. It comprised of a case matched study o
f 285 women with uncomplicated singleton past-term pregnancy (290-301 days
of gestation) and 855 women with uncomplicated singleton term pregnancy (25
9-287 days of gestation). Term controls were matched to post-term cases on
a 3:1 basis. The main outcome measures were cesarian section. Apgar scores
and admission to the Neonatal intensive care unit (NICU). Cesarian section
was significantly more common in women with post-term pregnancy (Relative R
isk = 1.90, 95 % CI = 1.29-2.85). The increase was equally distributed betw
een cesarian sections performed for failure to progress in labor (RR = 1.74
, 95 % CI = 1.02-3.04) and fetal distress (RR = 2.00, 95 % CI = 1.14-3.61).
There were no differences in low Apgar scores, but admission to the NICU w
as more common in the post-term group (RR = 2.69, 95 % CI = 1.39-5.54). The
re was no difference in significant neonatal pathology in either group. Unc
omplicated post-term pregnancy is associated with increased rates of obstet
ric and neonatal interventions in terms of cesarian section and NICU admiss
ions. This effect does not appear to be a result of underlying pathology as
sociated with post-term pregnancy. We suggest that a lower threshold for cl
inical intervention in pregnancies perceived to be,,at-risk" may be a signi
ficant contributing factor.