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Elective Induction of Labor Tied to Reduced Perinatal Mortality

No increase in C-sections noted, but increase in admissions to neonatal units

FRIDAY, May 11 (HealthDay News) -- Elective induction of labor between 37 and 41 weeks of gestation is associated with a reduction in perinatal mortality but an increase in admission to neonatal units, compared with expectant management, according to a study published online May 10 in BMJ.

Sarah J. Stock, Ph.D., from the University of Edinburgh in the United Kingdom, and colleagues retrospectively analyzed data from 1,271,549 women with singleton pregnancies of 37 weeks or more of gestation in Scotland from 1981 to 2007. Elective induction of labor was defined as having no recognized medical indication to induce labor.

The researchers found that, at each completed week of gestation between 37 and 41 weeks, elective induction of labor was associated with a decreased odds of perinatal mortality compared with expectant management. At 40 weeks of gestation, the odds of perinatal mortality was 0.08 percent (37 of 44,764) in the induction group compared to 0.18 percent (627 of 350,643) in the expectant management group (adjusted odds ratio [aOR], 0.39; 99 percent confidence interval [CI], 0.24 to 0.63). There was a positive association between admission to a neonatal unit and elective induction of labor at all gestations before 41 weeks. At 40 weeks of gestation, the rate of neonatal admission was 8.0 percent (3,605 of 44,778) in the induction group compared with 7.3 percent (25,572/350,791) in the expectant management group (aOR, 1.14; 99 percent CI, 1.09 to 1.20).

"Although residual confounding may remain, our findings indicate that elective induction of labor at term gestation can reduce perinatal mortality in developed countries without increasing the risk of operative delivery," the authors conclude.

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