Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions

To evaluate the likelihood of cesarean births, related to race, ethnicity, socioeconomic status (SES), maternal education and age, and gestational status for labor inductions on primiparous and multiparous women.

A retrospective descriptive correlational design was used with 1,325 women scheduled for induction at a large tertiary hospital in a southwestern U.S. state from January 1 through December 31, 2005. Birth outcomes were matched against inpatient hospital scheduling induction logs to verify the reason for induction, whether elective or clinically indicated.

Age and gestation had nonlinear and significant associations with cesarean birth. Elective inductions for primiparous women significantly increased the likelihood of cesarean delivery. The independent effect of being a primiparous woman with an elective induction increased the probability of a cesarean birth by 50%, but this association was not significant for multiparous women. Mother's educational level was a significant predictor for cesarean births with multiparous women being induced. Ethnicity and SES did not increase the odds of cesarean delivery following labor induction for either primiparous women or multiparous women.

Elective inductions for primiparous women increased the probability of cesarean births. Elective labor induction for primiparous women should be offered with caution, particularly for women with advanced maternal age.