The Association of Decision-to-Incision Time for Cesarean Delivery with Maternal and Neonatal Outcomes

William A. Grobman, Jennifer Bailit, Grecio Sandoval, Uma M. Reddy, Ronald J. Wapner, Michael W. Varner, John M. Thorp, Steve N. Caritis, Mona Prasad, Alan T.N. Tita, George R. Saade, Yoram Sorokin, Dwight J. Rouse, Sean C. Blackwell, Jorge E. Tolosa

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective The objective of this study was to estimate whether the decision-to-incision (DTI) time for cesarean delivery (CD) is associated with differences in maternal and neonatal outcomes. Methods This analysis is of data from women at 25 U.S. medical centers with a term, singleton, cephalic nonanomalous gestation and no prior CD, who underwent an intrapartum CD. Perinatal and maternal outcomes associated with DTI intervals of ≤ 15, 16 to 30, and > 30 minutes were compared. Results Among 3,482 eligible women, median DTI times were 46 and 27 minutes for arrest and fetal indications for CD, respectively (p < 0.01). Women with a fetal indication whose DTI interval was > 30 minutes had similar odds to the referent group (DTI of 16-30 minutes) for the adverse neonatal and maternal composites (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.40-1.71 and OR: 0.89, 95% CI: 0.63-1.27). For arrest disorders, the odds of the adverse neonatal composite were lower among women with a DTI of > 30 minutes (OR: 0.25, 95% CI: 0.08-0.77), and the adverse maternal composite was no different (OR: 1.15, 95% CI: 0.81-1.63). Conclusion In this analysis, DTI times longer than 30 minutes were not associated with worse maternal or neonatal outcomes.

Original languageEnglish (US)
Pages (from-to)247-253
Number of pages7
JournalAmerican Journal of Perinatology
Issue number3
StatePublished - Feb 1 2018


  • cesarean delivery
  • decision-to-incision interval
  • maternal outcomes
  • perinatal outcomes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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