Changes in obstetrical practices and pregnancy outcomes following the ARRIVE trial

The ARRIVE trial demonstrated the benefit of induction of labor at 39 weeks gestation. Obstetrics departments across the United States faced the challenge of adapting clinical practice in light of these data while managing logistical constraints. To determine if there were changes in obstetrical pra...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2022-05, Vol.226 (5), p.716.e1-716.e12
Main Authors: Gilroy, Laura C., Al-Kouatly, Huda B., Minkoff, Howard L., McLaren, Rodney A.
Format: Article
Language:English
Subjects:
39 weeks induction
ARRIVE trial
cesarean delivery rate
Cesarean Section
Female
Humans
induction of labor
Infant, Newborn
Infant, Newborn, Diseases
nulliparous
perinatal outcomes
Pregnancy
Pregnancy Outcome
Retrospective Studies
Seizures
Surface-Active Agents
United States - epidemiology
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Summary:The ARRIVE trial demonstrated the benefit of induction of labor at 39 weeks gestation. Obstetrics departments across the United States faced the challenge of adapting clinical practice in light of these data while managing logistical constraints. To determine if there were changes in obstetrical practices and perinatal outcomes in the United States after the ARRIVE trial publication. This was a population-based retrospective cohort study of low-risk, nulliparous women who initiated prenatal care by 12 weeks gestation with singleton, nonanomalous pregnancies delivering at ≥39 weeks. Data were obtained from the US Natality database. The pre-ARRIVE group were women who delivered between January 1, 2015 and December 31, 2017. The post-ARRIVE group consisted of women who delivered between January 1, 2019 and December 31, 2019. Births that occurred in 2018 were excluded. Practice outcomes were rates of induction of labor, timing of delivery, and cesarean delivery rate. Adverse maternal outcomes were blood transfusion and admission to medical intensive care unit. Adverse neonatal outcomes were need for assisted ventilation (immediate and >6 hours), 5-minute APGAR score
ISSN:0002-9378
1097-6868
1097-6868
DOI:10.1016/j.ajog.2022.02.003