Journal article
Association of Intended Mode of Delivery With Neonatal and Maternal Outcomes at 22-25 Weeks of Gestation
O&G open, Vol.3(1), e144
02/2026
DOI: 10.1097/og9.0000000000000144
PMID: 41550916
Abstract
To compare the risk of neonatal and maternal morbidity and mortality among individuals who delivered between 22 and 25 weeks of gestation by intended mode of delivery.
This was a secondary analysis of an observational cohort including participants with a singleton pregnancy delivered by planned cesarean delivery or after a trial of labor from 22 0/7 to 25 6/7 weeks of gestation. This analysis was limited to those who received both antenatal steroids and neonatal resuscitation. The primary outcome was a composite of neonatal death or severe neonatal morbidity. Secondary outcomes included neonatal mortality and measures of neonatal and maternal morbidity. Multivariable logistic regression analyses were used to adjust for prespecified covariates.
Among 277 eligible individuals, 149 (53.8%) had a planned cesarean delivery, and 128 (46.2%) had a trial of labor, of whom 12 (9.4%) delivered by cesarean. The two groups were similar except for more frequent hypertensive disorders (47.7% vs 26.6%,
<.001) and lower median birth weight (620 g versus 660 g,
=.02) among those with planned cesarean delivery. There was no difference in the primary neonatal composite outcome (73.8% vs 79.7%, adjusted odds ratio [AOR] 0.68, 95% CI, 0.35-1.33) between groups or secondary neonatal outcomes. Planned cesarean delivery was associated with a higher frequency of maternal sepsis (6.0% vs 1.6%, AOR 8.28, 95% CI, 1.32-51.8) and postpartum readmission (8.1% vs 0.8%, AOR 12.0, 95% CI, 1.48-97.5) compared with trial of labor. Other adverse maternal outcomes were more frequent among planned cesarean deliveries but were not statistically significant.
In this multisite registry, there was no difference in composite neonatal mortality or severe morbidity based on the intended mode of delivery, as well as no difference in secondary neonatal outcomes. Planned cesarean delivery was associated with increased maternal morbidity.
Details
- Title: Subtitle
- Association of Intended Mode of Delivery With Neonatal and Maternal Outcomes at 22-25 Weeks of Gestation
- Creators
- Jameaka L HamiltonPaula L McGeeBaha M SibaiMichael W VarnerAlan T N TitaMonica LongoEdward F BellBarbara J StollJohn M Thorp JrUma M ReddyHeather A FreyEmily S MillerDwight J RouseHyagriv N SimhanJennifer L BailitLorraine DugoffGeorge R SaadeEunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
- Resource Type
- Journal article
- Publication Details
- O&G open, Vol.3(1), e144
- DOI
- 10.1097/og9.0000000000000144
- PMID
- 41550916
- NLM abbreviation
- O G Open
- ISSN
- 2994-9726
- eISSN
- 2994-9726
- Grant note
- UG1 HD087230 / NICHD NIH HHS UG1 HD027851 / NICHD NIH HHS UG1 HD040485 / NICHD NIH HHS UG1 HD040545 / NICHD NIH HHS UG1 HD027915 / NICHD NIH HHS UG1 HD053097 / NICHD NIH HHS UG1 HD053109 / NICHD NIH HHS UG1 HD034208 / NICHD NIH HHS UG1 HD040560 / NICHD NIH HHS UG1 HD040544 / NICHD NIH HHS
- Language
- English
- Date published
- 02/2026
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9985129576502771
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