So 39 weeks is the full term cut off now?

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Im sure everyone has seen AWHONN's campaign to reduce elective inductions and ceseareans before 39 weeks but does that mean 39 weeks is the full term cut off now? Is it no longer 37 weeks? I ask as both an OB nurse and a woman who is currently 37 weeks pregnant. I was so relieved that I finally made it to term but my doctor told me to be patient because my baby needs to stay in for two more weeks to reach maximum maturity. Is this the new standard or does my doctor just want to torture his patients? Am I supposed to be telling my antepartum patients that 39 weeks is the new full term too (namely the ones who bombard me with questions about castor oil and nipple stimulation as soon as they hit 37 weeks)?

Specializes in Community, OB, Nursery.
Question: Why would 41 week inductions necessarily all be closed , thick , high? Some people go weeks dilated several cm before they go into labor. My sister in law was induced the day before her 40th week and she was already 3 or 4 cm before induction. Ok never mind. Maybe I was reading this wrong. Are you saying the study is biased?

I'm not saying that every single 41-week induction is closed-thick-high, but a lot are, esp the primes.

What I'm saying is that the study is artificially tilted toward better outcomes with a 39-week induction because the study is only studying 39-weekers with favorable Bishop scores vs. standard post-dates inductions. They're not comparing closed/thick/high 39-weekers with closed/thick/high 41-weekers. So yes, I'm saying there may be a bit of bias introduced here.

Specializes in Nurse Scientist-Research.

What I'm saying is that the study is artificially tilted toward better outcomes with a 39-week induction because the study is only studying 39-weekers with favorable Bishop scores vs. standard post-dates inductions. They're not comparing closed/thick/high 39-weekers with closed/thick/high 41-weekers. So yes, I'm saying there may be a bit of bias introduced here.

Yes! Potentially very biased. I guess it would be unethical to randomize all 39 weekers and 41 weekers and induce them regardless. I'm sure the researchers will assure us that they are going to be "controlling" for Bishop scores. Hope their statisticians are extremely balanced. Does the Eunice Kennedy foundation have a vested interest that you can tell? Sorry, research is kind of my thing now (PhD program).

Also saw this was a nation-wide study. Also learned last semester that one of the "tricks of the trade" is that very large samples can easily reach statistical significance even when the true effect size is negligible. Food for thought.

Specializes in Labor and Delivery.

Simply said, "yes". The March of Dimes among others have made a great effort to promote waiting until at least 39 weeks to electively induce labor. Inducing prior to 39 weeks is still allowed if there is a suspected medical reason that may compromise the pregnancy if delivery is delayed, i.e. oligohydramnios, growth restriction, diabetes, preeclampsia, etc. The fetus benefits from the extra maturity of the brain by delaying until at least 39 weeks. It would be presented best to your antepartum patients that the "womb" not the "hospital room" is the best place for the baby until 39 weeks.

Specializes in Nurse Leader specializing in Labor & Delivery.

Also saw this was a nation-wide study. Also learned last semester that one of the "tricks of the trade" is that very large samples can easily reach statistical significance even when the true effect size is negligible. Food for thought.

It's nationwide, but there are only 15 facilities across the nation where this study is being conducted. I don't know what the desired N is, but I can find out.

Other than that, I don't think I am following what you're saying.

Specializes in Nurse Scientist-Research.
It's nationwide, but there are only 15 facilities across the nation where this study is being conducted. I don't know what the desired N is, but I can find out.

Other than that, I don't think I am following what you're saying.

It's kind of a nerdy statistical hair-splitting thing. Statistical significance merely means there is a low likelihood that any difference is a true difference as opposed to mere variation one might expect by chance (that's the p

It was kind of a pet topic for my advanced statistics professor last semester.

It is unlikely that a study with only 15 centers participating is going to generate sample sizes so large as to be concerned about the problem I described.

Specializes in Nurse Leader specializing in Labor & Delivery.

Yeah, I understand what statistical significance is. It tells us the likelihood that the observed results are due to chance. The p value should be less than 0.05 for something to be considered statistically significant. (g-d I hate statistics, I have the phrases "null hypothesis" and "Type I errors" floating through my brain right now). I've just never heard of the idea that a larger sample size is a BAD thing in research, which is what I'm inferring from your posts.

Specializes in Nurse Scientist-Research.
I've just never heard of the idea that a larger sample size is a BAD thing in research, which is what I'm inferring from your posts.

Not "bad". Just important to recognize that not every statistically significant finding is clinically significant. That's why I wanted to know if the funding agency had a vested interest. Their reports can gloss over small effect sizes and focus on "statistical significance".

Specializes in Nurse Leader specializing in Labor & Delivery.
Not "bad". Just important to recognize that not every statistically significant finding is clinically significant.

Ah, yes. Now I understand.

Statistical significance should be mentioned in every well-designed study.

The funding agency is the NIH.

Specializes in Community, OB, Nursery.

Also saw this was a nation-wide study. Also learned last semester that one of the "tricks of the trade" is that very large samples can easily reach statistical significance even when the true effect size is negligible. Food for thought.

Yes. I'm in a DNP program and we also learned this in our stats & design class. Which has taught me to be much more skeptical than I was already.

Specializes in Nurse Leader specializing in Labor & Delivery.

Hey, thought of you guys this morning! I'm doing data collection on my thesis project, and I'm seeing firsthand what you meant by "the larger the sample size, the easier it is to get statistical significance". So far, my pre/post intervention data is not statistically significant, but if I can add more N to the pre-intervention, I may be able to get there (can't add more to the post-intervention due to time).

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