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Poster Session 3

Category: Hypertension

Poster Session 3

(885) Planned mode of delivery in preterm births complicated by hypertension: the impact of clinical/sociodemographic characteristics

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Moti Gulersen, MD, MSc

Assistant Professor
Thomas Jefferson University
PHILADELPHIA, Pennsylvania, United States

Coauthor(s)

IH

Itai Hazan

Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel
EL

Erez Lenchner, PhD

Biostatistics and Data Management
New York University Rory Meyers College of Nursing
New York, New York, United States
Vincenzo Berghella, MD (he/him/his)

Professor, Director
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Eran Bornstein, MD

Vice Chair of Obstetrics
Northwell
New Hyde Park, New York, United States

Objective:
To evaluate the planned mode of delivery in preterm births (PTBs) complicated by hypertensive disorders of pregnancy (HDP) and whether clinical and sociodemographic factors influence it.

Study Design:
Retrospective analysis of the Centers for Disease Control and Prevention Natality Live Birth database (2016-2023). All nulliparous, singleton, in-hospital, live births with HDP (i.e. gestational hypertension or preeclampsia) from 23 0/7-36 6/7 weeks of gestation were eligible for inclusion. Births with congenital anomalies, non-cephalic presentation, or missing data were excluded. Preterm births were stratified into 3 gestational age (GA) groups: 23 0/7-27 6/7, 28 0/7-33 6/7, and 34 0/7-36 6/7 weeks. Several clinical and sociodemographic factors were compared between patients undergoing a trial of labor (TOL) and those who had a planned cesarean delivery (PCD) within each GA group. Multivariable logistic regression was performed to evaluate the association of each factor with odds of TOL. Data are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results:
Of the 147,944 nulliparous, singleton, HDP patients at 23-36 weeks included, 66.1% underwent a TOL and 33.9% PCD. Rates of TOL were lowest in the earliest GA group and increased with advancing GA (23 0/7-27 6/7 weeks: 19.0% [1,016/5,355], 28 0/7-33 6/7 weeks: 39.4% [13,816/35,101], 34 0/7-36 6/7 weeks: 77.2% [83,001/107,488] (Figure, P< 0.01). Clinical factors such as older maternal age and higher body mass index were associated with increased odds of PCD (Table). Sociodemographic factors such as maternal education, race and ethnicity, and insurance type had minimal to no impact on the mode of delivery (Table).

Conclusion:
Mode of delivery in nulliparous PTBs complicated by HDP is GA dependent, with PCD much more common at early GAs. Clinical factors such as older maternal age and higher body mass index were associated with increased odds of PCD. These findings suggest that delivery planning in nulliparous PTBs complicated by HDP is primarily influenced by GA, maternal age, and BMI.