Is induced labour in the nullipara associated with more maternal and perinatal morbidity?

TY - JOUR

T1 - Is induced labour in the nullipara associated with more maternal and perinatal morbidity?

AU - Selo-Ojeme, Dan

AU - Rogers, Cathy

AU - Mohanty, Ashok

AU - Zaidi, Naseem

AU - Villar, Rose

AU - Shangaris, Panicos

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Purpose To ascertain any differences in foetomaternal outcomes in induced and spontaneous labour among nulliparous women delivering at term. Methods A retrospective matched cohort study consisting of 403 nulliparous women induced at ≥292 days and 806 nulliparous women with spontaneous labour at 285-291 days. Results Compared to those in spontaneous labour, women who had induction of labour were three times more likely to have a caesarean delivery (OR 3.1, 95% CI 2.4-4.1; P<0.001). Women who had induction of labour were 2.2 times more likely to have oxytocin augmentation (OR 2.2, 95% CI 1.7-2.8; P<0.001), 3.6 times more likely to have epidural anaesthesia (OR 3.6, 95% CI 2.8-4.6; P<0.001), 1.7 times more likely to have uterine hyperstimulation (OR 1.7, 95% CI 1.1-2.6), 2 times more likely to have a suspicious foetal heart rate trace (OR 2.0, 95% CI 1.5-2.6), 4.1 times more likely to have blood loss over 500 ml (OR 4.1, 95% CI 2.9-5.5; P<0.001), and 2.9 times more likely to stay in hospital beyond 5 days (OR 2.9, 95% CI 1.5-5.6; P<0.001). Babies born to mothers who had induction of labour were significantly more likely to have an Apgar score of <5 at 5 min and an arterial cord pH of <7.0. Conclusion Compared to those with spontaneous labour, nulliparous women with induced labours are more likely to have uterine hyperstimulation, caesarean delivery, and babies with low Apgar scores. Nulliparous women should be made aware of this, as well as potential risks of expectant management during counseling.

AB - Purpose To ascertain any differences in foetomaternal outcomes in induced and spontaneous labour among nulliparous women delivering at term. Methods A retrospective matched cohort study consisting of 403 nulliparous women induced at ≥292 days and 806 nulliparous women with spontaneous labour at 285-291 days. Results Compared to those in spontaneous labour, women who had induction of labour were three times more likely to have a caesarean delivery (OR 3.1, 95% CI 2.4-4.1; P<0.001). Women who had induction of labour were 2.2 times more likely to have oxytocin augmentation (OR 2.2, 95% CI 1.7-2.8; P<0.001), 3.6 times more likely to have epidural anaesthesia (OR 3.6, 95% CI 2.8-4.6; P<0.001), 1.7 times more likely to have uterine hyperstimulation (OR 1.7, 95% CI 1.1-2.6), 2 times more likely to have a suspicious foetal heart rate trace (OR 2.0, 95% CI 1.5-2.6), 4.1 times more likely to have blood loss over 500 ml (OR 4.1, 95% CI 2.9-5.5; P<0.001), and 2.9 times more likely to stay in hospital beyond 5 days (OR 2.9, 95% CI 1.5-5.6; P<0.001). Babies born to mothers who had induction of labour were significantly more likely to have an Apgar score of <5 at 5 min and an arterial cord pH of <7.0. Conclusion Compared to those with spontaneous labour, nulliparous women with induced labours are more likely to have uterine hyperstimulation, caesarean delivery, and babies with low Apgar scores. Nulliparous women should be made aware of this, as well as potential risks of expectant management during counseling.

KW - Caesarean section

KW - Induction of labour

KW - Neonatal outcome

KW - Pregnancy complication

KW - Spontaneous labour

UR - http://www.scopus.com/inward/record.url?scp=80052324996&partnerID=8YFLogxK

U2 - 10.1007/s00404-010-1671-2

DO - 10.1007/s00404-010-1671-2

M3 - Article

C2 - 20838800

AN - SCOPUS:80052324996

SN - 0932-0067

VL - 284

SP - 337

EP - 341

JO - Archives of Gynecology and Obstetrics

JF - Archives of Gynecology and Obstetrics

IS - 2

ER -