Induced labor after 39 weeks in healthy women may reduce need for C section

NIH-funded study suggests this approach may also reduce risk of preeclampsia, need for newborn respiratory support.

What

Healthy first-time mothers whose labor was induced in the 39th week of pregnancy were less likely to have a cesarean delivery, compared to a similar group who were not electively induced at 39 weeks, according to a study funded by the National Institutes of Health. Women in the induced group were also less likely to experience pregnancy-related blood pressure disorders, such as preeclampsia, and their infants were less likely to need help breathing in the first 3 days.

The study results(link is external) will be presented at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas on Feb. 1 at 11 a.m. EST.

Current guidelines recommend against elective induction of labor — inducing labor without a medical reason — in women in their first pregnancy prior to 41 weeks because of concern of increased need for cesarean delivery. Elective induction at 39 weeks, however, has become more common in recent years. NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) funded this study to determine whether elective induction is beneficial or harmful compared to expectant management (waiting for labor to begin naturally and intervening if problems occur).

More than 6,100 first-time mothers in the NICHD Maternal Fetal Medicine Units Network were randomly assigned to induced labor or to expectant management. Cesarean delivery was less frequent in the induced labor group (19 percent) versus the expectant management group (22 percent). Preeclampsia and gestational hypertension occurred in 9 percent of the induced group and 14 percent of the expectant management group. Among newborns, 3 percent in the induced group needed respiratory support, compared to 4 percent in the expectant management group.

Who

Uma Reddy, M.D., NICHD Pregnancy and Perinatology Branch, study co-investigator, is available for comment.

Abstract

Grobman, W. LBO1: A randomized trial of elective induction of labor at 39 weeks compared with expectant management of low-risk nulliparous women. American Journal of Obstetrics and Gynecology. January 2018. http://dx.doi.org/10.1016/j.ajog.2017.12.016(link is external).

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD conducts and supports research in the United States and throughout the world on fetal, infant and child development; maternal, child and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit https://www.nichd.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH…Turning Discovery Into Health®