Labor induction at term without identified indication: Maternal and neonatal outcomes

Abstract

NEONATAL OUTCOMES MICHAEL BRADY, SHARRY VERES, JAMES BALDUCCI, St. Joseph’s Hospital and Medical Center, Department of Obstetrics and Gynecology, Phoenix, Arizona, St. Joseph’s Hospital and Medical Center, Department of Family Medicine, Phoenix, Arizona OBJECTIVE: This study was undertaken to evaluate the risks of labor induction without an identified indication in uncomplicated term pregnancies. STUDY DESIGN: The 94,594 Arizona births during 2004 were reviewed for all singleton, non-breech deliveries that occurred from 37-41 weeks gestation. Cohorts of induced vs. spontaneous labor were created, excluding identifiable maternal and fetal indications for labor induction. Fetal and maternal outcomes were analyzed. RESULTS: In the induction cohort, 3.4% of neonates required short-term ventilatory assistance (less than 30 minutes), while only 1% of the spontaneously labored children required such assistance (relative risk, 2.39, 95% confidence interval 2.22-2.57). The relative risk of cesarean section in nulliparous women with induction of labor was 1.42, (95% confidence interval 1.351.50). Cesarean section was not increased in parous women. Several other outcomes also demonstrated significant differences. CONCLUSION: In this population, labor induction without identifiable indication more than doubled the relative risk of short-term neonatal ventilatory assistance. It also increased the risk of cesarean section in nulliparous patients.