Gestational age–specific severe maternal morbidity associated with labor induction

Objective The purpose of this study was to examine the association between labor induction and gestational age–specific severe maternal morbidity. Study Design Our study was restricted to women who delivered singletons at 37-42 weeks' gestation who had no pregnancy complications from 2003-2010...

Full description

Saved in:
Bibliographic Details
Published in:American journal of obstetrics and gynecology 2013-09, Vol.209 (3), p.209.e1-209.e8
Main Authors: Liu, Shiliang, MD, PhD, Joseph, K.S., MD, PhD, Hutcheon, Jennifer A., PhD, Bartholomew, Sharon, MHSc, León, Juan Andrés, MD, MSc, Walker, Mark, MD, Kramer, Michael S., MD, Liston, Robert M., MBCh
Format: Article
Language:English
Subjects:
Adult
Female
Gestational Age
Humans
labor induction
Labor, Induced - adverse effects
Logistic Models
Maternal Age
Morbidity
Obstetrics and Gynecology
Pregnancy
pregnancy complication
severe maternal morbidity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective The purpose of this study was to examine the association between labor induction and gestational age–specific severe maternal morbidity. Study Design Our study was restricted to women who delivered singletons at 37-42 weeks' gestation who had no pregnancy complications from 2003-2010 (n = 1,601,253) in Canada (excluding Quebec). Using a pregnancies-at-risk approach, the week-specific rates of specific morbidity after induction were contrasted with rates among ongoing pregnancies. Logistic regression was used to adjust for confounders. Results Induction increased the rate of postpartum hemorrhage that required blood transfusion at 38 weeks' gestation (adjusted rate ratio, 1.28; 95% confidence interval, 1.11–1.49) and 39 weeks' gestation (adjusted rate ratio, 1.21; 95% confidence interval, 1.06–1.38). Induction was also associated with higher rates of pueperal sepsis at 38 and 39 weeks' gestation and venous thromboembolism at 38 weeks' gestation. The absolute increase in morbidity rates was small; the number needed to harm was large (eg, 1270 for postpartum hemorrhage with blood transfusion at 38 weeks' gestation). Conclusion Among women without pregnancy complications, induction at earlier term is associated with higher rates of specific severe maternal morbidity, although absolute risks are low.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2013.05.033