Document Detail


Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes.
MedLine Citation:
PMID:  24084532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
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:
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:
Title:  Obstetrics and gynecology     Volume:  122     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-02     Completed Date:  2013-11-26     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  761-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
California / 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:
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:
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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