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Retrospective study of maternal and neonatal outcomes after induction compared to spontaneous start of labour in women with one previous birth in uncomplicated pregnancies ≥ 41+3

Lindegren, Lina LU ; Stuart, Andrea LU ; Carlsson Fagerberg, Marie LU and Källén, Karin LU (2021) In Journal of Perinatal Medicine 49(1). p.23-29
Abstract

To study the association between induction and outcome among two-parous women in uncomplicated pregnancies ≥ 41+3, stratified by first labour delivery mode and conditions present at first delivery. The Swedish Medical Birth Register was used to identify 58,964 uncomplicated singleton pregnancies among women with one previous birth between 1998 and 2014. Women with any registered pregnancy complications were excluded to minimise the risk for indication bias. The outcomes considered were emergency caesarean section (CS), and poor neonatal outcome (Apgar score <7 at 5 min, neonatal death, or meconium aspiration). Women who were induced at their second labour had higher emergency CS rates compared to women in spontaneously started... (More)

To study the association between induction and outcome among two-parous women in uncomplicated pregnancies ≥ 41+3, stratified by first labour delivery mode and conditions present at first delivery. The Swedish Medical Birth Register was used to identify 58,964 uncomplicated singleton pregnancies among women with one previous birth between 1998 and 2014. Women with any registered pregnancy complications were excluded to minimise the risk for indication bias. The outcomes considered were emergency caesarean section (CS), and poor neonatal outcome (Apgar score <7 at 5 min, neonatal death, or meconium aspiration). Women who were induced at their second labour had higher emergency CS rates compared to women in spontaneously started deliveries (adjusted risk ratio, ARR: 2.11; 95% CI: 2.00-2.23). Low Apgar score was more common after induction compared to spontaneously started labours (1.0 vs. 0.7%) (ARR: 1.44; 95% CI: 1.18-1.77). Increased CS rates were also found when comparing induction at 41 + 3 to 41 + 6 weeks to labour at 42 weeks or more, regardless of labour start (ARR 1.39; 95% CI: 1.26-1.52). We found an increased risk of CS and poor neonatal outcome after second labour induction in prolonged pregnancies. The second labour vaginal success rate after induction was highly dependent, on first labour delivery mode, but also on diagnoses and conditions present at the first delivery.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
caesarean section, delivery mode, induction, late term pregnancy, neonatal morbidity, parity, post-term pregnancy
in
Journal of Perinatal Medicine
volume
49
issue
1
pages
7 pages
publisher
De Gruyter
external identifiers
  • scopus:85091132405
  • pmid:32829318
ISSN
0300-5577
DOI
10.1515/jpm-2020-0312
language
English
LU publication?
yes
id
36e22e42-f1bb-47e7-8b8a-327ac51fba98
date added to LUP
2020-11-20 12:49:56
date last changed
2024-03-05 14:50:00
@article{36e22e42-f1bb-47e7-8b8a-327ac51fba98,
  abstract     = {{<p>To study the association between induction and outcome among two-parous women in uncomplicated pregnancies ≥ 41+3, stratified by first labour delivery mode and conditions present at first delivery. The Swedish Medical Birth Register was used to identify 58,964 uncomplicated singleton pregnancies among women with one previous birth between 1998 and 2014. Women with any registered pregnancy complications were excluded to minimise the risk for indication bias. The outcomes considered were emergency caesarean section (CS), and poor neonatal outcome (Apgar score &lt;7 at 5 min, neonatal death, or meconium aspiration). Women who were induced at their second labour had higher emergency CS rates compared to women in spontaneously started deliveries (adjusted risk ratio, ARR: 2.11; 95% CI: 2.00-2.23). Low Apgar score was more common after induction compared to spontaneously started labours (1.0 vs. 0.7%) (ARR: 1.44; 95% CI: 1.18-1.77). Increased CS rates were also found when comparing induction at 41 + 3 to 41 + 6 weeks to labour at 42 weeks or more, regardless of labour start (ARR 1.39; 95% CI: 1.26-1.52). We found an increased risk of CS and poor neonatal outcome after second labour induction in prolonged pregnancies. The second labour vaginal success rate after induction was highly dependent, on first labour delivery mode, but also on diagnoses and conditions present at the first delivery.</p>}},
  author       = {{Lindegren, Lina and Stuart, Andrea and Carlsson Fagerberg, Marie and Källén, Karin}},
  issn         = {{0300-5577}},
  keywords     = {{caesarean section; delivery mode; induction; late term pregnancy; neonatal morbidity; parity; post-term pregnancy}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{23--29}},
  publisher    = {{De Gruyter}},
  series       = {{Journal of Perinatal Medicine}},
  title        = {{Retrospective study of maternal and neonatal outcomes after induction compared to spontaneous start of labour in women with one previous birth in uncomplicated pregnancies ≥ 41<sup>+3</sup>}},
  url          = {{http://dx.doi.org/10.1515/jpm-2020-0312}},
  doi          = {{10.1515/jpm-2020-0312}},
  volume       = {{49}},
  year         = {{2021}},
}