Abstract
OBJECTIVE: To investigate the impact of the decision-to-delivery interval (DDI) on maternal and neonatal outcomes in women with a positive oxytocin challenge test (OCT), so as to provide evidence for establishing the optimal timing for cesarean delivery after a positive OCT. METHODS: A retrospective analysis was conducted on 191 singleton pregnant women who underwent cesarean delivery due to a positive OCT at our Hospital between January 2020 and May 2025. Participants were grouped based on DDI thresholds of 75 minutes and 90 minutes, respectively. Baseline characteristics, surgical indicators, and maternal and neonatal outcomes were compared. RESULTS: No significant differences were observed in baseline characteristics between the groups. At the 75-minute threshold: The short DDI group showed significantly higher postoperative white blood cell and neutrophil counts (P < 0.01) and a higher rate of DDI-related NICU admissions within 24 hours (20.00% vs 6.11%, P<0.05*), although no differences were found in major perinatal outcomes. At the 90-minute threshold: The short DDI group had higher rates of DDI-related NICU admissions (14.47% vs 5.66%, P<0.05*) and maternal postoperative fever (11.76% vs 0.94%, P = 0.003). Major maternal and neonatal outcomes still showed no significant improvement. CONCLUSION: Based on our data, a short DDI (≤75/90 minutes) in women with a positive OCT did not significantly improve major maternal or neonatal outcomes and may be associated with an increased postoperative inflammatory response and a higher risk of neonatal NICU admission. These findings highlight the complexity of DDI management and indicate the need for further investigation in prospective studies to determine the optimal DDI.