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Observational Study
. 2018 Feb;35(3):247-253.
doi: 10.1055/s-0037-1606641. Epub 2017 Sep 15.

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

William A Grobman  1 , Jennifer Bailit  2 , Grecio Sandoval  3 , Uma M Reddy  4 , Ronald J Wapner  5 , Michael W Varner  6 , John M Thorp Jr  7 , Steve N Caritis  8 , Mona Prasad  9 , Alan T N Tita  10 , George R Saade  11 , Yoram Sorokin  12 , Dwight J Rouse  13 , Sean C Blackwell  14 , Jorge E Tolosa  15 ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network
Affiliations
Observational Study

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

William A Grobman et al. Am J Perinatol. 2018 Feb.

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.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the study population EGA = estimated gestational age; DTI = decision-to-interval time
See this image and copyright information in PMC

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