The impact of duration of labor induction on cesarean rate.

Abstract:

OBJECTIVE:We sought to determine maternal factors that influence success of labor induction and whether the probability of cesarean delivery changed with time during induction. STUDY DESIGN:We performed a retrospective cohort study of 1650 singleton pregnancies induced at a gestation of 37 weeks or longer, with birthweights of 2500 g or greater, and without congenital anomalies. We used multivariate logistic regression to calculate odds ratios for cesarean. RESULTS:Nulliparity (odds ratio [OR] 7.8, 95% confidence interval [CI] 5.7 to 11), hypertension (OR 1.4, 95% CI 1.1 to 1.8), diabetes (OR 2.2, 95% CI 1.6 to 3.1), maternal age 28.8 years old or older (OR 1.3, 95% CI 1.2 to 1.4), and birthweight of 3441 g or greater (OR 1.6, 95% CI 1.2 to 2.0) were significantly associated with cesarean. Cesarean risk increased linearly with time by an average of 3.8% per 6 hours. CONCLUSION:Risk of cesarean increases over the duration of induction but does not reach clinical certainty. Cesarean probability is greater with nulliparity, hypertension, diabetes, older maternal age, or higher birthweight. Inductions without stated indications may not carry an increased risk of cesarean.

journal_name

Am J Obstet Gynecol

authors

Michelson KA,Carr DB,Easterling TR

doi

10.1016/j.ajog.2008.06.072

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

299.e1-4

issue

3

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(08)00704-7

journal_volume

199

pub_type

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