Inducing Labor at 41 Weeks May Cut Stillbirth Rates
Rates lower compared with a wait-and-see approach with induction at 42 weeks
THURSDAY, Nov. 21, 2019 (HealthDay News) -- In women with a low-risk pregnancy, induction at 41 weeks of gestation may be safer than a wait-and-see approach to 42 weeks, according to a study published online Nov. 20 in The BMJ.
Ulla-Britt Wennerholm, M.D., Ph.D., from Gothenburg University in Sweden, and colleagues randomly assigned 2,760 women with a low-risk, uncomplicated singleton pregnancy (1:1) to either the induction group at 41 weeks (1,381 women) or the expectant management group with induction at 42 weeks (1,379 women). Perinatal outcomes were compared between the groups.
The study was stopped early due to a significantly higher rate of perinatal mortality in the expectant management group. The researchers found that the two groups did not vary in the composite primary perinatal outcome (2.4 percent in the induction group and 2.2 percent in the expectant management group; relative risk, 1.06, 95 percent confidence interval, 0.65 to 1.73; P = 0.90). However, there were no perinatal deaths in the induction group and six (five stillbirths and one early neonatal death) in the expectant management group. The groups had similar outcomes with respect to the proportion of cesarean delivery, instrumental vaginal delivery, or any major maternal morbidity.
"Although these results should be interpreted cautiously, induction of labor ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths," the authors write.