Maternal and neonatal outcomes after induction of labor: a population-based study
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To evaluate maternal and neonatal outcomes at and beyond term associated with induction of labor compared to spontaneous onset of labor stratified by week of gestational age.
In this retrospective cohort study, data form 402,960 singleton pregnancies from the Austria Perinatal Registry were used to estimate odds ratios of secondary cesarean delivery, operative vaginal delivery, epidural analgesia, fetal scalp blood testing, episiotomy, 3rd/4th-degree lacerations, retained placenta, 5-min APGAR <7, umbilical artery pH <7.1, and admission to neonatal intensive care unit. Multivariate logistic regression models based on deliveries with gestational age ≥37 + 0 were applied for adjustment for possible confounders.
Induction of labor was associated with increased odds for cesarean delivery (adjusted OR; 99% confidence interval: 1.53; 1.45–1.60), operative vaginal delivery (1.21; 1.15–1.27), epidural analgesia (2.12; 2.03–2.22), fetal scalp blood testing (1.40; 1.28–1.52), retained placenta (1.32; 1.22–1.41), 5-min APGAR <7 (1.55; 1.27–1.89), umbilical artery pH <7.1 (1.26; 1.15–1.38), and admission to neonatal intensive care unit (1.41; 1.31–1.51). In a subgroup of induction of labor with the indication, “post-term pregnancy” induction was similarly associated with adverse outcomes.
In Austria, induction of labor is associated with increased odds of adverse maternal and neonatal outcomes. However, due to residual confounding, currently, no recommendations for treatment can be derived.
KeywordsCesarean section Cohort study Epidural analgesia Induction of labor Maternal outcomes Neonatal outcomes
- 1.Martin JA, Hamilton BE, Osterman MJ et al (2015) Births: final data for 2013. Natl Vital Stat Rep 64(1):1–65Google Scholar
- 2.EURO-PERISTAT Project with SCPE and EUROCAT (2013) European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010Google Scholar
- 3.Osterman MJK, Martin JA (2014) Recent declines in induction of labor by gestational age. NCHS Data Brief (155):1–8Google Scholar
- 4.Oberaigner W, Leitner H (2015) Geburtenregister Österreich: Bericht Geburtsjahr 2014. IET, InnsbruckGoogle Scholar
- 8.Caughey AB, Sundaram V, Kaimal AJ et al. (2009) Systematic review: elective induction of labor versus expectant management of pregnancy. Ann Intern Med 151(4): 252–63, W53–63Google Scholar
- 29.Schneider KTM, Butterwegge M, Daumer M et al (2014) S1-guideline on the use of CTG during pregnancy and labor: Long version - AWMF Registry No. 015/036. Geburtshilfe Frauenheilkd 74(8):721–732. doi:10.1055/s-0034-1382874
- 33.Heimstad R, Romundstad PR, Eik-Nes SH et al (2006) Outcomes of pregnancy beyond 37 weeks of gestation. Obstet Gynecol 108(3 Pt 1): 500–508. doi:10.1097/01.AOG.0000227783.65800.0f