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Maternal and neonatal outcomes following induction of labor: a cohort study
Rosalie M Grivell1, Aimee J Reilly, Helena Oakey
1Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia, Australia. rosalie.grivell@adelaide.edu.au
Objective:
To evaluate maternal and neonatal outcomes associated with birth at term by week of gestational age and also by onset of labor.
Design:
Cohort study.
Setting:
A state-wide perinatal outcome database.
Population:
28,626 women with spontaneous onset of labor, induction of labor for recognized indications and induction of labor for non-recognized indications.
Methods:
Cohort study utilizing a validated dataset comparing outcomes with type of onset of labor using a log binomial model.
Main Outcome Measures:
Cesarean section, assisted vaginal birth, important measures of maternal and neonatal morbidity.
Results:
Induction of labor for non-recognized indications was associated with a significantly increased risk of a range of outcomes, including cesarean section (RR 1.67, 95% CI 1.55-1.80). The lowest risk of adverse maternal and infant outcome occurred with birth between 38 and 39 weeks and with the spontaneous onset of labor.
Conclusions:
Induction of labor for non-recognized indications at term is associated with an increased risk of adverse outcomes. Caution is warranted with a liberal policy of induction of labor at term in an otherwise uncomplicated pregnancy.
