Is Elective Induction Linked to Lower Risk of C-section?
BACKGROUND AND PURPOSE:
Grobman and Caughey (AJOG, 2019) sought to
determine the association between elective induction at 39 weeks and mode of
delivery and other perinatal outcomes
Systematic review and meta-analysis
Compared induction at 39 weeks with expectant
management without other medical indication for induction
Data for nulliparous women available
Primary outcome: Association between labor
induction at 39 weeks and cesarean delivery
Association between labor induction at 39 weeks
and adverse pregnancy outcomes
6 cohort studies
66,019 women induced at 39 weeks | 584,390 women
Elective induction at 39 weeks compared to expectant
management was associated with lower frequencies for the following
26.4% vs 29.1%
Relative risk (RR) 0.83 (95% CI 0.74–0.93)
2.8% vs 5.2%
RR 0.53 (95% CI 0.39–0.72)
0.7% vs. 1.5%
RR 0.71 (95% CI 0.59–0.85)
Meconium aspiration syndrome
0.7% vs. 3.0%
RR 0.49 (95% CI 0.26–0.92)
Neonatal intensive care unit admission
3.5% vs. 5.5%
RR 0.80 (95% CI 0.72–0.8)
0.04% vs. 0.2%
RR 0.27 (95% CI 0.09–0.76)
This meta-analysis of observational studies is consistent with the recent ARRIVE RCT, demonstrating fewer cesarean sections and fewer maternal and neonatal complications in the 39-week induction group compared to expectant management
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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