• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

Is Elective Induction Linked to Lower Risk of C-section?

image_pdfFavoriteLoadingFavorite

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

METHODS:

  • Systematic review and meta-analysis
  • Study eligibility
    • Observational
    • 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
  • Secondary outcomes
    • Association between labor induction at 39 weeks and adverse pregnancy outcomes  

RESULTS:

  • 6 cohort studies
    • 66,019 women induced at 39 weeks | 584,390 women managed expectantly

Elective induction at 39 weeks compared to expectant management was associated with lower frequencies for the following

  • Cesarean delivery
    • 26.4% vs 29.1%
    • Relative risk (RR) 0.83 (95% CI 0.74–0.93)
  • Peripartum infection
    • 2.8% vs 5.2%
    • RR 0.53 (95% CI 0.39–0.72)
  • Respiratory morbidity
    • 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)
  • Perinatal mortality
    • 0.04% vs. 0.2%
    • RR 0.27 (95% CI 0.09–0.76)

CONCLUSION:

  • 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

Learn more – Primary Sources:

Elective induction of labor at 39 weeks compared to expectant management: A meta-analysis of cohort studies

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone

Learn More  »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

The ARRIVE Trial and Professional Guidance: Elective 39 Week Induction to Reduce the Risk of Cesarean Section
Induction vs Expectant Management At and Beyond Term – the Cochrane Review
Practical info on evidence based medicine for your women's healthcare practice
Labor Induction and an Unripe Cervix: Does it Result in More C-sections?

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

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.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site