Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies.

Background: Despite advances in healthcare, stillbirth rates remain relatively unchanged. We conducted a systematic review to quantify the risks of stillbirth and neonatal death at term (from 37 weeks gestation) according to gestational age.

Methods And Findings: We searched the major electronic databases Medline, Embase, and Google Scholar (January 1990-October 2018) without language restrictions.

Vaginal assessment and expedited amniotomy in oral misoprostol labor induction in nulliparas: a randomized trial.

Background: Labor is induced in 20-30% of maternities, with an increasing trend of use. Labor induction with oral misoprostol is associated with reduced risk of cesarean deliveries and has a safety and effectiveness profile comparable to those of mechanical methods such as Foley catheter use. Labor induction in nulliparous women continues to be challenging, with the process often quite protracted.

Maternal and fetal characteristics associated with meconium-stained amniotic fluid.

Objective: To estimate the rates of meconium-stained amniotic fluid (AF) and adverse outcome in relation to gestational age and racial group, and to investigate the predictors of meconium-stained AF.

Methods: We studied 499,096 singleton births weighing at least 500 g, at 24 or more weeks of gestation, from 1988 to 2000. The predictors of meconium-stained AF from 37 weeks of gestation onward were determined using multiple logistic regression.

Timing of planned cesarean delivery by racial group.

Objective: To estimate the incidence of newborn respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN) in relation to gestational age and planned cesarean delivery in white, South Asian, and black women.

Methods: Included in this study were 442,596 white, South Asian, and black women who delivered single live infants at 28 of weeks gestation onwards between 1988 and 2000. Using multiple logistic regression, the gestation-specific patterns of RDS for all deliveries and RDS plus TTN for deliveries by planned cesarean delivery were analyzed by racial group.

Race, prematurity and immaturity.

Compared to white Europeans, Blacks and South Asians have a significantly shorter mean gestational length and a higher incidence of preterm birth. For any given gestational age before 37 weeks, Black and South Asian babies have less risk of respiratory distress syndrome, and the survival rate in Black babies is higher than white Europeans. From 37 weeks of gestation onwards, the perinatal mortality rate in Blacks is higher than in white Europeans, and this appears to be associated with a higher rate of meconium passage and respiratory morbidity.

Racial variation in the association between gestational age and perinatal mortality: prospective study.

Objectives: To determine if the risks of perinatal mortality and antepartum stillbirth associated with post term birth increase earlier during pregnancy in South Asian and black women than in white women, and to investigate differences in the factors associated with antepartum stillbirth between the racial groups.

Design: Prospective study using logistic regression analysis.

Setting: 15 maternity units in northwest London from 1988 to 2000.

Are reported preterm birth rates reliable? An analysis of interhospital differences in the calculation of the weeks of gestation at delivery and preterm birth rate.

We investigated the possibility of preterm birth misclassification as a determinant of variation in its reported rates. Using a database of 497,105 deliveries from 17 hospitals, the best estimate of gestational age made at delivery and entered into the database at that time was recalculated from the menstrual dates and mid-trimester ultrasound scan. The recalculated completed weeks of gestation at delivery was compared with that made at birth.