Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women

Rachel G. Sinkey, Christina T. Blanchard, Jeff M. Szychowski, Elizabeth Ausbeck, Akila Subramaniam, Cherry L. Neely, Brian M. Casey, Alan T. Tita

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

OBJECTIVE:To compare perinatal and maternal outcomes in low-risk multiparous women who underwent elective induction of labor in the 39th week of gestation with those who were expectantly managed.METHODS:We performed a single center retrospective cohort study of low-risk multiparous women delivering nonanomalous singletons between 39 and 42 completed weeks of gestation from 2014 to 2018. The primary outcome was a perinatal composite of death, neonatal respiratory support, a 5-minute Apgar score of 3 or less, and shoulder dystocia. Groups were compared using χ2, Fisher exact, two sample t-test, and Wilcoxon rank sum tests, as appropriate. Multivariable logistic regression models were used to adjust for potential confounders.RESULTS:Of the 3,703 low-risk multiparous women meeting inclusion criteria, 453 (12%) delivered between 39 0/7 and 39 4/7 after an elective induction of labor. Women who underwent elective induction of labor were more likely to be privately insured, non-Hispanic, and weigh more at their first prenatal visit (all P<.01) compared with expectant management. An elective induction of labor was associated with decreased frequency of the perinatal composite morbidity (4.0% vs 7.1%; adjusted odds ratio [aOR] 0.57, 95% CI 0.34-0.96) compared with expectant management. Fewer cesarean deliveries occurred among women in the elective induction of labor group (5.1% vs 6.6%; aOR 0.60, 95% CI 0.37-0.97). Other maternal outcomes (hypertensive disorders, chorioamnionitis, and operative vaginal deliveries) as well as neonatal intensive care unit admissions were not different between groups.CONCLUSION:Elective induction of labor in low-risk multiparous women in the 39th week of gestation was associated with decreased perinatal morbidity and a lower frequency of cesarean delivery compared with expectant management.

Original languageEnglish (US)
Pages (from-to)282-287
Number of pages6
JournalObstetrics and gynecology
Volume134
Issue number2
DOIs
StatePublished - Aug 1 2019

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Sinkey, R. G., Blanchard, C. T., Szychowski, J. M., Ausbeck, E., Subramaniam, A., Neely, C. L., Casey, B. M., & Tita, A. T. (2019). Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women. Obstetrics and gynecology, 134(2), 282-287. https://doi.org/10.1097/AOG.0000000000003371