Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with...

This study aims to compare outcomes of induction with planned cesarean in women with preeclampsia.

A retrospective cohort study, including women with singleton pregnancies, preeclampsia (mild, severe, and superimposed), and without previous cesarean at ≥ 34 weeks' gestation was conducted. Outcomes included primary outcome (intensive care unit [ICU] admission, thromboembolism, transfusion, and hysterectomy), composite severe neonatal outcome (asphyxia, arterial cord pH < 7.0, hypoxic-ischemic encephalopathy, and 5-minute Apgar score < 5), neonatal ICU (NICU) admission, transient tachypnea of newborn (TTN), and respiratory distress syndrome (RDS). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, controlling for confounders.

Of 5,506 women with preeclampsia at ≥ 34 weeks' gestation, 5,104 (92.7%) women underwent induction. Induction compared with planned cesarean was not associated with an increased risk of the primary outcome but was related to increased risks of ICU admission (aOR: 3.29; 95% CI: 1.02-10.64), and linked to decreased risks of composite neonatal outcome (aOR: 0.32; 95% CI: 0.10-0.99), NICU admission (aOR: 0.60; 95% CI: 0.43-0.84), TTN (aOR: 0.38; 95% CI: 0.22-0.64), and RDS (aOR: 0.44; 95% CI: 0.22-0.86).

Induction was not associated with an increased risk of the primary outcome but was associated with an increased risk of ICU admission and decreased risks of neonatal outcomes.