{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:18:17Z","timestamp":1787242697823,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,2,10]],"date-time":"2014-02-10T00:00:00Z","timestamp":1391990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,10]]},"abstract":"\n Objective<\/jats:title>\n \n To compare composite maternal and neonatal morbidities (\n CMM<\/jats:styled-content>\n ,\n CNM<\/jats:styled-content>\n ) among nulliparous women with primary indications for caesarean section (\n CS<\/jats:styled-content>\n ) as acute clinical emergency (group I;\n ACE<\/jats:styled-content>\n ), non\u2010reassuring fetal heart rate (group\n II<\/jats:styled-content>\n ) and arrest disorder (group\n III<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A multicentre prospective study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n Nineteen academic centres in the\n USA<\/jats:styled-content>\n , with deliveries in 1999\u20132002.\n <\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n Nulliparous women (\n n\u00a0=\u00a0<\/jats:italic>\n 9829) that had\n CS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Nulliparous women undergoing\n CS<\/jats:styled-content>\n for three categories of indications were compared using logistic regression model, adjusted for five variables.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n CMM<\/jats:styled-content>\n was defined as the presence of any of the following: intrapartum or postpartum transfusion, uterine rupture, hysterectomy, cystotomy, ureteral or bowel injury or death;\n CNM<\/jats:styled-content>\n was defined as the presence of any of the following: umbilical arterial p\n H<\/jats:styled-content>\n <7.00, neonatal seizure, cardiac, hepatic, renal dysfunction, hypoxic ischaemic encephalopathy or neonatal death.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The primary reasons for\n CS<\/jats:styled-content>\n were\n ACE<\/jats:styled-content>\n in 1% (group I,\n n\u00a0=\u00a0<\/jats:italic>\n 114) non\u2010reassuring\n FHR<\/jats:styled-content>\n in 29% (group\n II<\/jats:styled-content>\n ;\n n\u00a0=\u00a0<\/jats:italic>\n 2822) and failed induction\/dystocia in the remaining 70% (group\n III<\/jats:styled-content>\n ;\n n\u00a0=\u00a0<\/jats:italic>\n 6893). The overall risks of\n CMM<\/jats:styled-content>\n and\n CNM<\/jats:styled-content>\n were 2.5% (95% confidence intervals,\n CI<\/jats:styled-content>\n , 2.2\u20132.8%) and 1.9% (95%\n CI<\/jats:styled-content>\n 1.7\u20132.2), respectively. The risk of\n CMM<\/jats:styled-content>\n was higher in group I than in group\n II<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 4.1, 95%\n CI<\/jats:styled-content>\n 3.1, 5.3), and group\n III<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 3.2, 95%\n CI<\/jats:styled-content>\n 2.7, 3.7). The risk of\n CNM<\/jats:styled-content>\n was also higher in group I than in group\n II<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 2.8, 95%\n CI<\/jats:styled-content>\n 2.3, 3.4) and group\n III<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 14.1, 95%\n CI<\/jats:styled-content>\n 10.7, 18.7).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Nulliparous women who have acute clinically emergent caesarean sections are at the highest risks of both composite maternal and neonatal morbidity and mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.12669","type":"journal-article","created":{"date-parts":[[2014,2,10]],"date-time":"2014-02-10T02:12:43Z","timestamp":1391998363000},"page":"1395-1402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Indications for caesarean sections at \u226534\u00a0weeks among nulliparous women and differential composite maternal and neonatal morbidity"],"prefix":"10.1111","volume":"121","author":[{"given":"SP","family":"Chauhan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Beydoun","sequence":"additional","affiliation":[{"name":"Graduate Program in Public Health Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IA","family":"Hammad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Babbar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JB","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mlynarczyk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ME","family":"D'Alton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology College of Physicians and Surgeons Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AZ","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM","family":"Vintzileos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Winthrop University Hospital Mineola NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CV","family":"Ananth","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology College of Physicians and Surgeons Columbia University New York NY USA"},{"name":"Department of Epidemiology Joseph L. Mailman School of Public Health Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,10]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Trends in caesarean rates for first births and repeat caesarean rates for low\u2010risk women: United States, 1990\u20132003","author":"Menacker F","year":"2005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.06.058"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.117364"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2010.00409.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e10c5c"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.12.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-010-1812-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1295653"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2006.07.003"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.03.043"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2011.01607.x"},{"key":"e_1_2_11_13_1","first-page":"676","article-title":"Unengaged vertex in nulliparous women in active labor: a risk factor for caesarean delivery","volume":"43","author":"Falzone S","year":"1998","journal-title":"J Reprod Med"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050600797483"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1040345"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31818475de"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000287294.89148.23"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(97)02725-5"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000219750.79480.84"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-004-0692-0"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.553695"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181744110"},{"key":"e_1_2_11_23_1","first-page":"436","article-title":"Appropriate technology for birth","author":"World Health Organization","year":"1985","journal-title":"Lancet"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.02.031"},{"key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/AOG.0b013e3182704880","article-title":"Preventing the first caesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal\u2010Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop","volume":"120","author":"Spong CY","year":"2012","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181a09fc0"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fdfb11"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fd2556"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.11.041"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040405"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000257121.56126.fe"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000224693.07785.14"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1903"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000236547.35234.8c"},{"key":"e_1_2_11_35_1","volume-title":"Neonatal encephalopathy and cerebral palsy: defining the pathogenesis and pathophysiology","author":"American College of Obstetricians and Gynecologists","year":"2003"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050500073134"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181bc6e15"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181d55925"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b8f28f"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2006.00690.x"},{"key":"e_1_2_11_41_1","first-page":"975","article-title":"Emergency caesarean delivery for nonreassuring fetal heart rate tracings. Compliance with ACOG guidelines","volume":"48","author":"Chauhan SP","year":"2003","journal-title":"J Reprod Med"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.02348.x"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107680009300703"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.043"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1285829"},{"key":"e_1_2_11_46_1","first-page":"288","article-title":"Caesarean section with relative indications versus spontaneous vaginal delivery: short\u2010term outcomes of maternofetal health","volume":"39","author":"Arikan I","year":"2012","journal-title":"Clin Exp Obstet Gynecol"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.09.029"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000259312.36053.02"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.039"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35379-8"}],"container-title":["BJOG: An International Journal of Obstetrics & Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.12669","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.12669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:11:31Z","timestamp":1695557491000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.12669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,10]]},"references-count":49,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1111\/1471-0528.12669"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.12669","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,10]]},"assertion":[{"value":"2013-12-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-02-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}