Inducing labour can reduce birth complications without increasing caesareans

Research published today highlights the risks and benefits of inducing babies late in pregnancy.

Babies induced at 37 weeks plus are at a reduced risk of death but have an increased chance of being admitted to a special babycare unit, according to the Scottish research.

A study led by the University of Edinburgh, UK, compared rates of perinatal mortality and maternal complications after planned induction compared with a decision to continue a pregnancy.

Researchers used Scottish birth and death records to analyse data for more than 1.2 million women with single pregnancies who gave birth after 37 weeks gestation between 1981 and 2007.

At each gestation between 37 and 41 weeks, planned induction of labour was associated with lower death rates compared with expectant management, without increasing the need for a caesarean section. For example, at 40 weeks gestation, there were 37 deaths out of 44,764 (0.08 per cent) in the induction group compared with 627 out of 350,643 (0.18 per cent) in the expectant management group.

Planned induction of labour was associated with increased rates of admission to a special care baby unit (eight per cent) compared with expectant management (7.3 per cent).

The authors say this means that for every 1,040 women having elective induction of labour at 40 weeks, one newborn death may be prevented, but this would result in seven more admissions to a special care baby unit.

The full results are published in the British Medical Journal.

Although there could be other factors that could the results, the authors conclude that planned induction of labour at term “has the potential to reduce perinatal mortality in developed countries without increasing the risk of operative delivery”.

Outcomes of elective induction of labour compared with expectant management: population based study. Stock S et al. BMJ. BMJ 2012;344:e2838 doi: 10.1136/bmj.e2838