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Morning compared with evening induction of labor: a nested randomized controlled trial. A nested randomized
Jodie M Dodd1, Caroline A Crowther, Jeffrey S Robinson
1The Department of Obstetrics and Gynaecology, the University of Adelaide, North Adelaide, South Australia, Australia. jodie.dodd@adelaide.edu.au
Obstetrics and Gynecology
|August 2, 2006
Summary
Morning induction of labor may reduce the need for oxytocin and operative vaginal birth. This study suggests morning admission for labor induction may offer benefits for some women.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Clinical Trials
Background:
- Induction of labor is a common obstetric procedure.
- The timing of labor induction may influence outcomes.
- Physiologic labor onset typically occurs in the early morning hours.
Purpose of the Study:
- To evaluate if morning induction of labor is associated with better outcomes compared to evening induction.
- To test the hypothesis that morning induction aligns better with natural labor onset.
Main Methods:
- Nested randomized clinical trial (April 2001-December 2004).
- Inclusion: Pregnant women >36+6 weeks gestation, cephalic presentation, scheduled for prostaglandin induction.
- Random assignment to morning (0800h) or evening (2000h) admission.
Main Results:
- No significant difference in vaginal birth within 24 hours, hyperstimulation, or cesarean delivery between groups.
- Morning admission was associated with less oxytocin use (45.0% vs 54.1%).
- Nulliparous women admitted in the morning had fewer operative vaginal births (16.1% vs 34.2%).
Conclusions:
- Morning admission for labor induction may be preferable.
- Consideration for morning admission for labor induction is recommended.
- Further research may explore optimal timing for labor induction.
