Outcomes of induced labour

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Neonatal Outcomes

Background:

• Labor induction is a common obstetric intervention.
• Understanding the impact of induction indications on maternal and neonatal outcomes is crucial for clinical decision-making.
• The Australian Council of Healthcare Standards (ACHS)/RACOG classification provides defined indications for labor induction.

Purpose of the Study:

• To review maternal and neonatal outcomes of labor in singleton pregnancies.
• To compare outcomes between spontaneous labor, labor induced for defined indications, and labor induced for non-defined indications.
• To evaluate the association between the indication for labor induction and delivery and neonatal outcomes.

Main Methods:

• Retrospective review of 1,405 pregnancies managed over a 12-month period.
• Inclusion criteria: singleton pregnancies > 20 weeks gestation, excluding planned Cesarean deliveries.
• Classification of induction indications using the ACHS/RACOG list; comparison of outcomes (instrumental vaginal delivery, Cesarean delivery, neonatal admission, 5-minute Apgar score) across groups.

Main Results:

• Labor was induced in 22.3% of cases (313/1405).
• Of induced labors, 53.7% (165/311) were for defined indications.
• No significant difference in adverse outcomes was observed between spontaneous labor and induction for non-defined indications. However, induction for defined indications was associated with significantly increased rates of instrumental vaginal delivery, Cesarean delivery, and adverse neonatal outcomes.

Conclusions:

• Labor induction for defined indications is associated with poorer maternal and neonatal outcomes.
• Induction for non-defined indications does not appear to significantly alter outcomes compared to spontaneous labor.
• These findings highlight the importance of carefully considering the indication for labor induction to optimize maternal and neonatal well-being.