The mortality risk of expectant management compared with delivery stratified by gestational age and race and ethnicity

Melissa G. Rosenstein, Jonathan M. Snowden, Yvonne W. Cheng, Aaron B. Caughey

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

OBJECTIVE: The objective of the study was to compare the mortality risk of expectant management with the risk of delivery at each week of term pregnancy in 4 racial/ethnic groups. STUDY DESIGN: This was a retrospective cohort study of all nonanomalous, term deliveries in California from 1997 to 2006 among white, black, Hispanic, and Asian women. In each racial/ethnic group, we compared the risk of infant death at each week with a composite risk representing the mortality risk of 1 week of expectant management. RESULTS: The risk of stillbirth and infant death is highest in black women (stillbirth risk: 18.0 per 10,000, infant death: 24.4 per 10,000, compared with 9.4 per 10,000 and 10.8 per 10,000 in white women, respectively; P <.001). Although absolute risks differ by race/ethnicity, the composite risk of expectant management does not surpass the risk of delivery until 39 weeks in any group. At 39 weeks these absolute risk differences are low, however, with a number needed to deliver to prevent 1 death ranging from 751 (among black women) to 2587 (among Asian women). CONCLUSION: The mortality risk of expectant management exceeds the risk of delivery at 39 weeks in all racial/ethnic groups, despite variation in absolute risks.

Original languageEnglish (US)
Pages (from-to)660.e1-660.e8
JournalAmerican journal of obstetrics and gynecology
Volume211
Issue number6
DOIs
StatePublished - Dec 1 2014

Keywords

  • expectant management
  • mortality risk
  • race/ethnicity
  • stillbirth

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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