Risk Factors for Cesarean Delivery in Preterm, Term and Post-Term Patients Undergoing Induction of Labor with an Unfavorable Cervix

Abstract

Background/Aims: To identify risk factors for cesarean delivery in patients with an unfavorable cervix undergoing an indicated induction of labor. Methods: This is a secondary analysis of combined data from three prospective randomized trials comparing cervical ripening methods in singleton pregnancies with an unfavorable cervix seeking to identify risk factors for cesarean delivery. Results: Nine hundred and five women underwent an induction of labor for a variety of indications. Gestational age ranged from 27.0–42.8 weeks (mean of 37.8 weeks) and initial Bishop’s score from 0–6 (mean 2.5). There were 613 vaginal deliveries (67.7%) and 292 cesarean deliveries (32.2%). Factors associated with an increased risk for cesarean delivery included nulliparous status, Bishop’s score ≤1, body mass index >40 and diabetes mellitus. Conclusions: Risk factors for cesarean delivery in women undergoing an indicated induction include a low Bishop’s score, high BMI, nulliparity and diabetes.