Academic journal article International Perspectives on Sexual and Reproductive Health

Elective Labor Induction Linked to Elevated Risk of Adverse Outcomes

Academic journal article International Perspectives on Sexual and Reproductive Health

Elective Labor Induction Linked to Elevated Risk of Adverse Outcomes

Article excerpt

Latin American women with low-risk pregnancies who undergo elective labor induction are at increased risk for adverse maternal and perinatal outcomes, compared with those who experience spontaneous labor, according to an eight-country study. (1) Women who opted for labor induction without any medical indication were more likely than those who delivered spontaneously to require drugs to manage postpartum hemorrhage (relative risk ratio, 1.5), be admitted to the intensive care unit (2.9), need anesthesia or pain-relieving medications and procedures during labor (1.6-3.7) and delay the initiation of breast-feeding (1.1-3.1). Women electing labor induction were ateo more likely than those delivering spontaneously to undergo hysterectomy (5.2), though the researchers note that caution should be exercised when interpreting this finding, given the small number of cases involved.

To determine the frequency of elective labor induction in Latin America, as well as the associations between elective induction and adverse maternal and perinatal outcomes, researchers performed a secondary analysis of cross-seciional data from the 2004-2005 World Health Organization ' Global Survey on Maternal and Perinatal Health. The data, collected on every delivery over a 2-3 month period, were obtained from the medical records of 120 randomly selected health facilities located in eight randomly chosen Latin American countries. In all, the L researchers analyzed 37,444 deliveries among women with low-risk pregnancies between 37 and 40 weeks of gestation. Multiple logistic regression models were run to determine the maternal and other characteristics associated: with elective labor induction and to assess the relative risks for adverse outcomes. Characteristics included in the analyses were maternal age, marital status, education, parity and body mass index: gestational age; and facility type.

Out of the 11,077 cases of induced labor, 1,847 (17%) were elective, representing 5% of deliveries among women with low-risk pregnancies. Administration of oxytocin was the most common method used for elective induction (66%), and led to vaginal delivery in 88% of cases; cesarean section was required in 12% of electively induced deliveries. Women who did not have a partner were less likely than those who did to have an elective induction (odds ratio, 0. …

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