Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Poster Session 1

(124) Outcomes among low-risk term multiparous births in California pre- and post-ARRIVE trial publication

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Following publication of the ARRIVE trial, term pregnancy management has changed for all patients. Although the ARRIVE trial included only nulliparous patients, its results may have been extrapolated to multiparous patients. Therefore, we assessed the differences in obstetric management and outcomes pre- and post-ARRIVE trial publication among multiparous patients who would have otherwise fit study criteria.

Study Design: This was a retrospective cohort study of singleton, non-anomalous, low-risk multiparous patients between 39-42 weeks of gestation in California. We excluded patients with a prior cesarean delivery, chronic hypertension, diabetes, breech presentation, advanced maternal age, oligohydramnios, polyhydramnios, and placental conditions requiring cesarean delivery. The pre- and post-ARRIVE trial publication cohorts were two years before and after 2018, 2016-2017 and 2019-2020, respectively. We assessed utilization of induction of labor and clinically relevant maternal and neonatal outcomes in the overall cohort, then stratified by week of gestation. Chi squared and multivariable logistic regression were used for statistical analyses.

Results: There were 149,214 births in 2016-2017 and 118,653 births in 2019-2020 that met our inclusion criteria. In the post-ARRIVE trial publication time period, induction of labor increased (24.2% vs. 29.5%, p< 0.001) and cesarean deliveries decreased (5.2% vs. 4.9%, p< 0.001). There were lower rates of NICU admission (7.3% vs. 6.3%, p< 0.001) and respiratory distress syndrome (0.25% vs. 0.21%, p=0.018). The adjusted odds of stillbirth were significantly lower at 39 weeks of gestation (aOR 0.52, 95% CI 0.48-0.96).

Conclusion: In this study, we found increased utilization of induction of labor and decreased rates of cesarean delivery, NICU admission, and respiratory distress syndrome pre- and post-publication of the ARRIVE trial. There was also a reduction in stillbirth at 39 weeks’ gestation. These results demonstrate that similar to nulliparas, a trend of increased delivery at 39 and 40 weeks’ gestation may improve perinatal outcomes in multiparas.