Labor induction in China: a nationwide survey

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Maternal-Fetal Medicine

Background:

• Overmedicalization of labor and delivery is a growing global concern.
• Epidemiological data on labor induction practices in China is limited.

Purpose of the Study:

• To determine the labor induction rate in China from 2015-2016.
• To assess the association between medical conditions and cesarean delivery among women undergoing induction.
• To compare maternal and neonatal outcomes of labor induction versus prelabor cesarean delivery in low-risk women.

Main Methods:

• Cross-sectional study utilizing data from 96 hospitals across 24 Chinese administrative divisions (2015-2016).
• Multivariable logistic regression to analyze factors associated with cesarean delivery post-induction.
• Linear regression to examine the relationship between prelabor cesarean delivery rates and labor induction rates.
• Comparative analysis of maternal and neonatal outcomes for labor induction versus prelabor cesarean delivery in low-risk populations.

Main Results:

• The overall labor induction rate in China was 14.2%, with 18.4% in nulliparous and 10.2% in multiparous women.
• Vaginal delivery rates were 72.9% for nulliparas and 86.6% for multiparas, irrespective of induction method.
• Higher rates of non-medically indicated cesarean delivery were associated with lower labor induction rates in nulliparas.
• Labor induction in low-risk women showed no increased risk of adverse maternal or neonatal outcomes compared to prelabor cesarean delivery.

Conclusions:

• The labor induction rate in China was 18.4% for nulliparas and 10.2% for multiparas between 2015-2016.
• The prevalence of prelabor cesarean delivery may influence regional variations in labor induction rates.
• Labor induction in low-risk women appears to be a safe alternative to prelabor cesarean delivery, without increasing severe maternal or neonatal morbidity.