Timing and consequences of early term and late term deliveries.

OBJECTIVE

To examine the timing of elective delivery and neonatal intensive care unit (NICU) utilization of electively delivered infants from 2008 to 2011.

METHODS

Analysis included 42,290 women with singleton gestation enrolled in a pregnancy education program, reporting uncomplicated pregnancies with elective labor induction (ELI) (n = 27,677) or scheduled cesarean delivery (SCD) (n = 14,613) at 37.0-41.9 weeks' gestation. Data were grouped by type and week of delivery (37.0-37.9, 38.0-38.9, and 39.0-41.9 weeks). ELI and SCD for each week of delivery from 2008 to 2011 and nursery utilization by delivery week were compared.

RESULTS

During the 2008-2011 timeframe, a shift in timing of ELI and SCD toward ≥39.0 weeks was observed. In 2008, 80.9% of ELI occurred at ≥39.0 weeks versus 92.6% in 2011 (p < 0.001). In 2008, 60.5% of SCD occurred at ≥39.0 weeks versus 78.1% in 2011 (p < 0.001). NICU admission and prolonged nursery stays were highest at 37.0-37.9 weeks for both groups.

CONCLUSIONS

We observed a shift toward later gestational age at elective delivery from 2008 to 2011 and increased NICU utilization for neonates born at <39 weeks' gestation.