Abstract
INDUCTION OF LABOR LENA KIM, ANJALI KAIMAL, YVONNE CHENG, SHANI DELANEY, ANGIE CHILD, AARON CAUGHEY, Kaiser Permanente, Obstetrics and Gynecology, Hayward, California, University of California, San Francisco, San Francisco, California OBJECTIVE: To determine if women with preeclampsia have a higher risk of labor induction failure than women without preeclampsia. STUDY DESIGN: We conducted a retrospective cohort study to examine cesarean delivery rates between women with and without preeclampsia undergoing labor induction in four subgroups: term nulliparous, term multiparous, preterm nulliparous, and preterm multiparous. We included all induced singleton pregnancies 24 weeks gestational age at a single institution. Multivariable logistic regression analysis was used to control for parity and gestational age, as well as other potential confounders (maternal age, race/ethnicity, prior cesarean history, epidural use, medical comorbidities, and BMI). RESULTS: Our cohort included 3,481 women. Term nulliparous preeclamptics had higher cesarean delivery rates than non-preeclamptics (n 1761, 33 v. 24%, p 0.003). Although not significant, term multiparous preeclamptics had more cesarean deliveries as well (n 1213, 17 v. 13%, p 0.305). Preterm preeclamptics also had significantly higher labor induction failure rates compared to non-preeclamptics among both nulliparous (n 254, 26 v. 7%, p 0.001) and multiparous (n 253, 26 v. 8%, p 0.001) women. In multivariable analysis preeclampsia still conferred an increased risk of labor induction failure (OR 1.88, 95% CI 1.38 2.56). CONCLUSION: Women with preeclampsia had higher failure rates of labor induction than women without preeclampsia regardless of parity or gestational age at delivery, even when controlling for other potential confounders.
Published Version
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