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Perinatal outcomes following an earlier post-term labour induction policy: a historical cohort study

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OBJECTIVE: To assess the changes in perinatal outcomes in children born from 37 weeks of gestation after implementation of a more proactive labour induction practice from 2009.

DESIGN: Register-based cohort study.

SETTING: Denmark, 2000-12.

POPULATION: Newborns from 37 weeks of gestation.

METHODS: Perinatal outcomes were estimated using a logistic regression analysis with adjustment for gestational age, maternal age, parity, plurality, smoking and body mass index.

MAIN OUTCOME MEASURES: Perinatal outcomes.

RESULTS: A total of 770 926 infants were included. Labour induction from 37 weeks increased from 9.7% in 2000-02 to 22.5% in 2011-12. From 2003-05 to 2011-12, the risk of umbilical cord pH < 7.0 decreased by 23%; odds ratio (OR) 0.77 (95% confidence interval 0.67-0.89), and the adjusted OR of Apgar score < 7 at 5 minutes was unchanged. The risk of admission to neonatal intensive care units increased by 56%; OR 1.56 (1.47-1.66), whereas the risk of neonatal deaths decreased by 44%; OR 0.56 (0.45-0.70). The risk of cerebral palsy was from 2000-02 to 2009-10 reduced by 26%; OR 0.74 (0.60-0.90). The proportion of infants born with fetal weight ≥ 4500 g decreased by one-third; OR 0.68 (0.65-0.71). However, the risk of shoulder dystocia increased by 32%; OR 1.32 (1.21-1.44), whereas the risk of peripheral nerve injuries was reduced by 43%; OR 0.57 (0.45-0.73).

CONCLUSION: The results suggest an overall improvement in perinatal outcomes as a result of a more proactive post-term labour induction practice.

Original languageEnglish
JournalBJOG : an international journal of obstetrics and gynaecology
Volume122
Issue number10
Pages (from-to)1377-85
Number of pages9
ISSN1470-0328
DOIs
Publication statusPublished - Sep 2015

    Research areas

  • Adult, Birth Injuries, Cohort Studies, Denmark, Female, Gestational Age, Humans, Infant, Infant Mortality, Infant, Newborn, Infant, Newborn, Diseases, Infant, Postmature, Intensive Care, Neonatal, Labor, Induced, Logistic Models, Outcome Assessment (Health Care), Pregnancy, Registries

ID: 46255583