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Labor Induction Versus Expectant Management-A Scoping Review of Randomized Controlled Trial Evidence
Premanjali Chowdhury1, Ilari Kuitunen1,2
1Faculty of Health Sciences, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
The Journal of Obstetrics and Gynaecology Research
|August 12, 2026
Summary
Induction of labor generally shows similar or improved neonatal outcomes compared to expectant management for most indications. However, effects vary by gestational age, especially in preterm settings, requiring careful consideration.
Area of Science:
- Obstetrics
- Neonatal Outcomes
- Evidence Synthesis
Background:
- Induction of labor is common but its neonatal impact versus expectant management remains unclear.
- Uncertainty exists regarding outcomes across different gestational ages and indications.
Purpose of the Study:
- To map randomized controlled trial (RCT) evidence comparing labor induction with expectant management.
- To focus on neonatal outcomes in singleton pregnancies.
Main Methods:
- Scoping review of PubMed, Scopus, and Web of Science.
- Included parallel-group RCTs comparing induction vs. expectant management with planned delay.
- Synthesized findings descriptively by clinical indication.
Main Results:
- Fifty RCTs (1987-2023) analyzed across various indications.
- Induction generally showed similar/improved neonatal outcomes in term/post-term pregnancies.
- Neonatal outcomes varied by gestational age in preterm/hypertensive conditions, with higher NICU admissions linked to prematurity.
Conclusions:
- RCT evidence suggests labor induction is not linked to worse neonatal outcomes for most indications.
- Effects are context-specific and gestational age-dependent, with preterm trade-offs.
- Heterogeneity and evidence gaps necessitate standardized outcomes and further research.
