Computational model for timing of delivery in an obese population. (16th February 2018)

• Record Type: Journal Article
• Authors: Gill, Lisa; Holbert, Michael
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 4(2018)
• Page Start: 469
• Page End: 473
• Publication Date: 2018-02-16
• Subjects: Obesity -- stillbirth -- delivery timing -- cesarean; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1288207
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To estimate the impact on stillbirth risk, cesarean deliveries, and delivery-related healthcare cost associated with induction of labor compared to expectant management of term pregnancies in an obese population. Methods: A decision analysis model was designed to compare the delivery and cost outcomes associated with a hypothetical cohort of 100, 000 term pregnancies, complicated by obesity, that were planning a vaginal delivery. The model predicted stillbirths, cesarean deliveries, and total delivery-related health care cost from routine induction at 39 weeks compared to expectant management and routine induction each week from 40 to 42 weeks. Results: There were 387 stillbirths avoided by routine induction at 39 weeks compared to the worst-case model of expectant management with induction at 42 weeks. 9234 cesarean deliveries were avoided by routine induction at 39 weeks compared to the worst-case model of expectant management and induction at 41 weeks (30, 888 vs. 40, 122) . Routine induction at 39 weeks showed a savings in delivery-related health care cost of 30 million dollars compared to the worst-case model of expectant management and induction at 41 weeks (536 million vs. 566 million). Conclusion: Utilizing this computational model, routine induction at 39 weeks minimizes stillbirths, cesarean deliveries, and delivery-related health care cost.