TY - JOUR
T1 - Maternal and neonatal outcomes after induction of labor without an identified indication
AU - Dublin, Sascha
AU - Lydon-Rochelle, Mona
AU - Kaplan, Robert C.
AU - Watts, D. Heather
AU - Critchlow, Cathy W.
N1 - Funding Information:
From the Department of Epidemiology,a the Department of Health Services,b the Department of Obstetrics and Gynecology,c the Medical Scientist Training Program,d and the Women’s Health Nursing Research Training Program,e University of Washington, and the Center for Research on Mothers and Children, Pediatric, Adolescent, Maternal AIDS Branch, National Institute of Child Health and Human Development.f Sascha Dublin, PhD, was supported in part by National Institute of General Medical Sciences grant 5T32GM007266 (Medical Scientist Training Program) and by an Achievement Rewards for College Scientists fellowship. Mona Lydon-Rochelle, MPH, CNM, PhD, was supported by Center for Women’s Health Research Training Award NIH-NINR 1 P30 NR04001. Robert C. Kaplan, PhD, was a Howard Hughes Medical Institute Predoctoral Fellow. Received for publication July 23, 1999; revised January 31, 2000; accepted February 23, 2000. Reprint requests: Cathy W. Critchlow, MD, Department of Epidemiology, B509 Health Sciences Bldg, Box 357475, Seattle, WA 98195. 6/1/106748 doi:10.1067/mob.2000.106748
PY - 2000
Y1 - 2000
N2 - OBJECTIVE: This study was undertaken to examine associations between induction of labor and maternal and neonatal outcomes among women without an identified indication for induction. STUDY DESIGN: This was a population-based cohort study of 2886 women with induced labor and 9648 women with spontaneous labor who were delivered at 37 to 41 weeks' gestation, all without identified medical and obstetric indications for induction. RESULTS: Among nulliparous women 19% of women with induced labor versus 10% of those with spontaneous labor underwent cesarean delivery (adjusted relative risk, 1.77; 95% confidence interval, 1.50-2.08). No association was seen in multiparous women (relative risk, 1.07; 95% confidence interval, 0.81-1.39). Among all women induction was associated with modest increases in instrumental delivery (19% vs 15%; relative risk, 1.20; 95% confidence interval, 1.09-1.32) and shoulder dystocia (3.0% vs 1.7%; relative risk, 1.32; 95% confidence interval, 1.02-1.69). CONCLUSION: Among women who lacked an identified indication for induction of labor, induction was associated with increased likelihood of cesarean delivery for nulliparous but not multiparous women and with modest increases in the risk of instrumental delivery and shoulder dystocia for all women.
AB - OBJECTIVE: This study was undertaken to examine associations between induction of labor and maternal and neonatal outcomes among women without an identified indication for induction. STUDY DESIGN: This was a population-based cohort study of 2886 women with induced labor and 9648 women with spontaneous labor who were delivered at 37 to 41 weeks' gestation, all without identified medical and obstetric indications for induction. RESULTS: Among nulliparous women 19% of women with induced labor versus 10% of those with spontaneous labor underwent cesarean delivery (adjusted relative risk, 1.77; 95% confidence interval, 1.50-2.08). No association was seen in multiparous women (relative risk, 1.07; 95% confidence interval, 0.81-1.39). Among all women induction was associated with modest increases in instrumental delivery (19% vs 15%; relative risk, 1.20; 95% confidence interval, 1.09-1.32) and shoulder dystocia (3.0% vs 1.7%; relative risk, 1.32; 95% confidence interval, 1.02-1.69). CONCLUSION: Among women who lacked an identified indication for induction of labor, induction was associated with increased likelihood of cesarean delivery for nulliparous but not multiparous women and with modest increases in the risk of instrumental delivery and shoulder dystocia for all women.
KW - Cesarean delivery
KW - Induction of labor
KW - Instrumental delivery
KW - Shoulder dystocia
UR - http://www.scopus.com/inward/record.url?scp=0033791753&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033791753&partnerID=8YFLogxK
U2 - 10.1067/mob.2000.106748
DO - 10.1067/mob.2000.106748
M3 - Article
C2 - 11035351
AN - SCOPUS:0033791753
SN - 0002-9378
VL - 183
SP - 986
EP - 994
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4
ER -