| Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes. | |
MedLine Citation:
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PMID: 24084532 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To test the association of elective induction of labor at term compared with expectant management and maternal and neonatal outcomes. METHODS: This was a retrospective cohort study of all deliveries without prior cesarean delivery in California in 2006 using linked hospital discharge and vital statistics data. We compared elective induction at each term gestational age (37-40 weeks) as defined by The Joint Commission with expectant management in vertex, nonanomalous, singleton deliveries. We used multivariable logistic regression to test the association of elective induction and cesarean delivery, operative vaginal delivery, maternal third- or fourth-degree lacerations, perinatal death, neonatal intensive care unit admission, respiratory distress, shoulder dystocia, hyperbilirubinemia, and macrosomia (birth weight greater than 4,000 g) at each gestational week, stratified by parity. RESULTS: The cesarean delivery rate was 16%, perinatal mortality was 0.2%, and neonatal intensive care unit admission was 6.2% (N=362,154). The odds of cesarean delivery were lower among women with elective induction compared with expectant management across all gestational ages and parity (37 weeks [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.34-0.57], 38 weeks [OR 0.43, 95% CI 0.38-0.50], 39 weeks [OR 0.46, 95% CI 0.41-0.52], 40 weeks [OR 0.57, CI 0.50-0.65]). Elective induction was not associated with increased odds of severe lacerations, operative vaginal delivery, perinatal death, neonatal intensive care unit admission, respiratory distress, shoulder dystocia, or macrosomia at any term gestational age. Elective induction was associated with increased odds of hyperbilirubinemia at 37 and 38 weeks of gestation and shoulder dystocia at 39 weeks of gestation. CONCLUSION: Elective induction of labor is associated with decreased odds of cesarean delivery when compared with expectant management. LEVEL OF EVIDENCE: : II. |
Authors:
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Blair G Darney; Jonathan M Snowden; Yvonne W Cheng; Lorie Jacob; James M Nicholson; Anjali Kaimal; Sascha Dublin; Darios Getahun; Aaron B Caughey |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 122 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2013 Oct |
Date Detail:
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Created Date: 2013-10-02 Completed Date: 2013-11-26 Revised Date: 2014-04-02 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 761-9 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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California
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epidemiology Cesarean Section / statistics & numerical data* Female Humans Infant, Newborn Infant, Newborn, Diseases / epidemiology* Intensive Care Units, Neonatal / statistics & numerical data Labor, Induced / adverse effects*, statistics & numerical data Logistic Models Perinatal Mortality Perineum / injuries Pregnancy Pregnancy Complications / epidemiology Retrospective Studies Surgical Procedures, Elective / adverse effects*, statistics & numerical data Term Birth |
| Grant Support | |
ID/Acronym/Agency:
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HS017582/HS/AHRQ HHS; K12 HD001262/HD/NICHD NIH HHS; K23 AG028954/AG/NIA NIH HHS; K23AG028954/AG/NIA NIH HHS |
| Comments/Corrections | |
Comment In:
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Obstet Gynecol. 2014 Feb;123(2 Pt 1):363
[PMID:
24451664
]
Obstet Gynecol. 2014 Feb;123(2 Pt 1):363 [PMID: 24451667 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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