{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T10:44:54Z","timestamp":1743849894407,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Stig and Ragna Gorthon Foundation"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Prolonged pregnancies are associated with adverse maternal and fetal outcome. In Sweden, no national guidelines exist for when to induce prolonged pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Singleton cephalic prolonged pregnancies (defined as \u2265 41<jats:sup>+3<\/jats:sup> gestational weeks) during 2001\u20132013 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0199\u00a0770) were identified using the Swedish Medical Birth Register. The maternity units were divided into three groups (tertiles) based on the proportion of pregnancies \u2265\u00a042<jats:sup>+3<\/jats:sup> gestational weeks among all pregnancies \u2265\u00a041<jats:sup>+3<\/jats:sup>\u00a0weeks. The pregnancy outcome among women delivered at the units with the most expectant management of prolonged pregnancies (&gt;\u00a017.6% proceeding to 42<jats:sup>+3<\/jats:sup>\u00a0weeks), was compared with that among women delivered at units with the most active management (&lt;\u00a012.6% proceeding to 42<jats:sup>+3<\/jats:sup>\u00a0weeks). Odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) were calculated using simple and multiple logistic regression. Adjustments were made for year of delivery, hospital level, maternal age, body mass index, and smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among primiparas, an increased risk of Apgar score &lt;\u00a07 at 5\u00a0minutes [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.27, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.16\u20131.41] and meconium aspiration (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.49, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.14\u20131.95) was found after birth at most expectant units compared with most active units, but among multiparas, no such associations were detected. A decreased rate of cesarean section was found for both primiparas (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.83, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.80\u20130.86) and multiparas (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.82, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.77\u20130.86) at units with expectant vs. active management. No association between perinatal death and delivery\u2010unit specific management of prolonged pregnancies was detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Offspring to primiparas might gain from a more active management of prolonged pregnancies, whereas no such improvement of neonatal outcome among multiparous women was detected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13237","type":"journal-article","created":{"date-parts":[[2017,9,30]],"date-time":"2017-09-30T07:32:39Z","timestamp":1506756759000},"page":"1467-1474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Improved neonatal outcome after active management of prolonged pregnancies beyond 41<sup>+2<\/sup>\u00a0weeks in nulliparous, but not among multiparous women"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5910-3907","authenticated-orcid":false,"given":"Lina","family":"Lindegren","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsingborg Hospital Helsingborg Sweden"},{"name":"Institution of Clinical Sciences Department of Obstetrics and Gynecology University of Lund Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsingborg Hospital Helsingborg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Herbst","sequence":"additional","affiliation":[{"name":"Institution of Clinical Sciences Department of Obstetrics and Gynecology University of Lund Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-2630","authenticated-orcid":false,"given":"Karin","family":"K\u00e4ll\u00e9n","sequence":"additional","affiliation":[{"name":"Institution of Clinical Sciences Department of Obstetrics and Gynecology University of Lund Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.ICD\u201010: International Statistical Classification of Diseases and Related Health Problems Tenth Revision: Volume 2: Second Edition: \u00a75.7.1. 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