The association between induction of labour at 38 to 39 weeks pregnancy and indication for caesarean delivery: An observational study

被引:4
|
作者
de Vries, Bradley Stephen [1 ,2 ]
McGeechan, Kevin [1 ]
Barratt, Alexandra [3 ]
Tooher, Jane [2 ]
Wong, Ebony [2 ]
Phipps, Hala [4 ]
Gordon, Adrienne [5 ,6 ]
Hyett, Jon Anthony [7 ,8 ]
机构
[1] Univ Sydney, Sch Publ Hlth, Sydney, NSW, Australia
[2] Royal Prince Alfred Hosp, RPA Women & Babies, Sydney, NSW, Australia
[3] Univ Sydney, Sch Publ Hlth, Wiser Hlth Care, Sydney, NSW, Australia
[4] Sydney Local Area Hlth Dist, Sydney, NSW, Australia
[5] Univ Sydney, Discipline Obstet Gynaecol & Neonatol, Sydney, NSW, Australia
[6] Univ Sydney, Charles Perkins Ctr, Sydney, NSW, Australia
[7] Royal Prince Alfred Hosp, Dept High Risk Obstet RPA Women & Babies, Sydney, NSW, Australia
[8] Univ Sydney, Discipline Obstet Gynaecol & Neonatol, Cent Clin Sch, Sydney, NSW, Australia
来源
AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY | 2019年 / 59卷 / 06期
基金
英国医学研究理事会;
关键词
caesarean section; labour induced; parturition; pregnancy; vaginal birth (no related term in MeSH); INTRAPARTUM INTERVENTION RATES; OUTCOMES FOLLOWING INDUCTION; EXPECTANT MANAGEMENT; ELECTIVE-INDUCTION; RISK; SECTION; BIRTH; WOMEN; TERM; AGE;
D O I
10.1111/ajo.13006
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BackgroundInduction of labour is associated with a reduction in caesarean delivery, but the mechanism of action and which groups of women might benefit remain unknown. AimsTo assess the association between induction of labour at 38-39 weeks pregnancy, and caesarean delivery: (i) overall; (ii) for slow progress in labour; and (iii) for suspected fetal compromise. Material and methodsRetrospective observational study in two Sydney hospitals from 2009 to 2016, among nulliparous women with induction of labour at 38 or 39 completed weeks pregnancy and a singleton, cephalic presenting fetus. The comparator was all planned vaginal births beyond 39((+1/7)) weeks, whether or not labour was induced. Binary and multinomial multiple logistic regressions adjusting for multiple confounders were performed. ResultsThere were 2388 and 15 259 women in the study and comparison groups respectively. Induction of labour was associated with caesarean delivery overall only for women <25 years of age (adjusted odds ratio 1.63; 95% CI 1.17-2.27) and was not associated with caesarean delivery for slow progress. Induction of labour was positively associated with increased caesarean delivery for suspected fetal compromise among young women (<30 years), with the association weakening as maternal age increased. The association between induction of labour and caesarean delivery was different for slow progress compared with suspected compromise (P = 0.005). ConclusionsInduction of labour has different effects on the likelihood of caesarean delivery for slow progress and for suspected fetal compromise. Women <30 years of age are at higher risk of caesarean delivery for suspected fetal compromise, potentially due to uterine hyperstimulation.
引用
收藏
页码:791 / 798
页数:8
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