Cesarean delivery rates have plateaued in the United States despite attempts at reduction. Dysfunctional labor is a major cause of cesarean delivery. Excessive inflammation in the setting of obesity and infection is suggested to be detrimental to the normal labor process. A recent pilot study performed at OU in the department of maternal-fetal medicine suggests that patients treated with intrapartum antibiotic prophylaxis (IAP) with cefazolin and azithromycin during labor induction had a lower rate of cesarean delivery than those receiving placebo. Previous studies have also suggested that the day of week and the time of day of induction play a role in the rate of cesarean delivery. The primary aim of this study is to examine the difference in cesarean delivery rate between patients who received GBS prophylaxis and those who did not. The secondary aim is to explore rate of cesarean delivery stratified by day of week and start time of induction.

We are performing a retrospective cohort study of nulliparous women who delivered at The Children’s Hospital at OU Medical Center. We plan to include patients undergoing induction of labor (IOL) between July 1, 2017 and July 1, 2022. The primary outcome will be cesarean delivery rate between those receiving GBS prophylaxis and who did not receive intrapartum antibiotics. The secondary outcomes include maternal morbidity, neonatal morbidity and mortality, as well as rate of cesarean delivery stratified by day of week and start time of induction