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

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 χ, 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

Fingerprint

Induced Labor
Risk Management
Pregnancy
Nonparametric Statistics
Logistic Models
Odds Ratio
Mothers
Morbidity
Chorioamnionitis
Dystocia
Apgar Score
Neonatal Intensive Care Units
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Sinkey, R. G., Blanchard, C. T., Szychowski, J. M., Ausbeck, E., Subramaniam, A., Neely, C. L., ... 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

Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women. / Sinkey, Rachel G.; Blanchard, Christina T.; Szychowski, Jeff M.; Ausbeck, Elizabeth; Subramaniam, Akila; Neely, Cherry L.; Casey, Brian M.; Tita, Alan T.

In: Obstetrics and gynecology, Vol. 134, No. 2, 01.08.2019, p. 282-287.

Research output: Contribution to journalArticle

Sinkey, RG, Blanchard, CT, Szychowski, JM, Ausbeck, E, Subramaniam, A, Neely, CL, Casey, BM & Tita, AT 2019, 'Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women', Obstetrics and gynecology, vol. 134, no. 2, pp. 282-287. https://doi.org/10.1097/AOG.0000000000003371
Sinkey, Rachel G. ; Blanchard, Christina T. ; Szychowski, Jeff M. ; Ausbeck, Elizabeth ; Subramaniam, Akila ; Neely, Cherry L. ; Casey, Brian M. ; Tita, Alan T. / Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women. In: Obstetrics and gynecology. 2019 ; Vol. 134, No. 2. pp. 282-287.
@article{40bd0c4896bc4651a7d20f1bed352c07,
title = "Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women",
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 χ, 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.",
author = "Sinkey, {Rachel G.} and Blanchard, {Christina T.} and Szychowski, {Jeff M.} and Elizabeth Ausbeck and Akila Subramaniam and Neely, {Cherry L.} and Casey, {Brian M.} and Tita, {Alan T.}",
year = "2019",
month = "8",
day = "1",
doi = "10.1097/AOG.0000000000003371",
language = "English (US)",
volume = "134",
pages = "282--287",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Elective Induction of Labor in the 39th Week of Gestation Compared With Expectant Management of Low-Risk Multiparous Women

AU - Sinkey, Rachel G.

AU - Blanchard, Christina T.

AU - Szychowski, Jeff M.

AU - Ausbeck, Elizabeth

AU - Subramaniam, Akila

AU - Neely, Cherry L.

AU - Casey, Brian M.

AU - Tita, Alan T.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - 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 χ, 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.

AB - 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 χ, 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.

UR - http://www.scopus.com/inward/record.url?scp=85070658975&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070658975&partnerID=8YFLogxK

U2 - 10.1097/AOG.0000000000003371

DO - 10.1097/AOG.0000000000003371

M3 - Article

C2 - 31306328

AN - SCOPUS:85070658975

VL - 134

SP - 282

EP - 287

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 2

ER -