optimal antenatal corticosteroids, pH < 7.1, and Apgar < 5. A backwards procedure was used to select those variables associated most strongly with TABLE 1 Admission characteristics PPROM (n ¼ 310) PTL (n ¼ 263) 10. The Hosmer-Lemeshow test was used to determine the goodness of fit of the final regression model. Statistical significance is defined as a P < 34 weeks, the primary indications for premature delivery were PTL and PPROM were the most frequent reasons for admission and each accounted for about one-third of all the premature deliveries and the composite morbidity rate using for these 2 diagnoses was in excess of 60% and the mortality rate was 4%.32 Given that the earlier gestational age chosen for the current study is < .003) odds ratio, 4.5; 95% CI 2.1 to 9.8) (Table 5). Comment Principal findings In this study, despite a substantial sample size and its prospective nature, we found no indications for obstetrical admission or indications for delivery that correlated with neonatal outcome in those delivered 5.078 Reason for admission variables are relative to PTL. Hosmer-Lemeshow goodness of fit P ¼ .3694. GA, gestational age; IUGR, intrauterine fetal growth restriction; PPROM, preterm prelabor rupture of membranes; PTL, preterm labor. Garite et al. Indications for obstetric admission and delivery and neonatal outcome. Am J Obstet Gynecol 2017. Original Research OBSTETRICS ajog.org 72.e7 American Journal of Obstetrics & Gynecology JULY 2017 Research implications Beyond confirming the findings of this study as currently designed, or repeating it with a larger sample size, there are little more in the way further studies that this current one may suggest. As previously mentioned, perhaps there may be some implications of indications for admission and/or delivery on outcome in later gestational ages. But because these later gestational ages infrequently have serious morbidities, the need for intensive counseling is less furthermore the likelihood one could show such differences in a study would be difficult because the lower frequencies of the morbidities would require much larger sample sizes. Conclusion Based on this and previous studies, patients with a variety indications for admission can be counseled similarly with regard to the likelihood of neonatal outcomes without requiring information to be tailored to the specific indication, and thus the counseling and management decisions can be based primarily on gestational age along with other factors, including estimated fetal weight, sex, race, plurality, and completion of a course of antenatal corticosteroids.4 Only in the case of suspected IUGR do we have clear evidence that reasons for admission and delivery can be expected to affect outcome beyond these factors. n Acknowledgments We acknowledge and thank the following individuals and institutions who participated as research coordinators: Kimberly Mallory, RNC, and Jasmin Bono (San Jose, CA); Dawn Artis, RN, and Guadalupe Weis, RN (Seattle, WA); Julie Rael, MS, and Jeri Lech, MS (Denver, CO); Kathleen Swearingen, PNNP (Kansas City, MO); Ana Braescu, MS, Michelle Games, RN, and Gloria Mullen, RN (Phoenix, AZ); Charlotte Engelke, RN (Laguna Hills, CA); Julia Yeoman, MD, and Jillian Rigdon, MD (St. Louis, MO); and Willa Tyler, RN, and Fonda Garza, RN (Fort Worth, TX). References 1. Stevenson DK, Wright LL, Lemons JA, et al. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1993 through December 1994. Am J Obstet Gynecol 1998;179:1632-9. 2. Fanaroff AA, Stoll BJ, Wright LL, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007;196:147.e1-8. 3. Manuck TA, Rice MM, Bailit JL, et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016;215. 103:e1-14. 4. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). NICHD Neonatal Research Network (NRN): Extremely Preterm Birth Outcome Data. Available at: https://www.nichd.nih.gov/about/org/ der/branches/ppb/programs/epbo/Pages/ epbo_case.aspx. Accessed April 6, 2017. 5. Ananth CV, Berkowitz GS, Savitz DA, Lapinski RH. Placental abruption and adverse perinatal outcomes. JAMA 1999;282:1646-51. 6. Salihu HM, Bekan B, Aliyu MH, et al. Perinatal mortality associated with abruptio placenta in singletons and multiples. Am J Obstet Gynecol 2005;193:198-203. 7. Oyelese Y, Ananth CV. Placental Abruption. Obstet Gynecol 2006;108:1005-16. 8. Vahanian A, Lavery JA, Ananth CV, Vintzileos A. Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis. Am J Obstet Gynecol 2011;213(suppl 4):378-90. 9. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol 2015;213: 193-201. 10. Hobel CJ, Hyvarinen MA, Oh W. Abnormal fetal heart rate pattern and fetal acid-base balance in low birth weight infants in relation to respiratory distress syndrome. Obstet Gynecol 1972;39:83. 11. Martin CB Jr, Siassi B, Hon EH. Fetal heart rate pattern and neonatal death in the low birth weight infant. Obstet Gynecol 1973;44:503. 12. Braly PS, Garite TJ, German JC. Fetal heart rate patterns in