August 08, 2018
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Induced labor lowers risk of cesarean delivery

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Women who underwent labor induction at 39 weeks gestation had a significantly reduced likelihood of a cesarean birth, as well as fewer maternal and newborn complications, according to research published in The New England Journal of Medicine.

“There’s a lot of controversy around the consequences of inducing labor. People were convinced that it increased the risk of cesarean delivery, but the reality was actually unknown,” William A. Grobman, MD, from the department of obstetrics and gynecology at Northwestern University, said in a press release.

Grobman and colleagues conducted a multicenter trial to compare the effects of induced labor and expectant management among low-risk nulliparous women. Participants were randomly assigned to receive either labor induction (n = 3,062) or expectant management (n = 3,044) at 39 weeks. Data on outcomes, including perinatal death, severe neonatal complications and cesarean delivery, were recorded.

The study revealed that more neonates in the expectant-management group experienced perinatal death and severe neonatal complications than those in the induction group (5.4% vs. 4.3%; RR = 0.8; 95% CI, 0.64-1). Cesarean delivery occurred significantly less often among women in the induction group compared with the expectant-management group (18.6% vs. 22.2%; RR = 0.84; 95% CI, 0.76-0.93).

Additionally, rates of preeclampsia and gestational hypertension were lower in the induction group than the expectant management group (9% vs. 14%). Rates of respiratory support among newborns was also lower in the induction group than the non-induction group (3% vs. 4%).

“This study provides evidence that inducing labor at 39 weeks actually reduces cesarean delivery,” Grobman said in the release.

“This new knowledge gives women the autonomy and ability to make more informed choices regarding their pregnancy that better fit with their wishes and beliefs,” he added. “Induction at 39 weeks should not be routine for every woman, but it’s important to talk with their provider and decide if they want to be induced and when.” – by Alaina Tedesco

Disclosure: Grobman reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.