Some previous studies have suggested that inducing labor in pregnant women may increase their need for a cesarean section, particularly in older pregnant women. However, a new study shows that inducing labor had no significant effect on the rate of cesarean sections or adverse health effects when it came to mother and baby.
Risks for stillbirth, preeclampsia pregnancy diabetes and issues with the placenta are all linked to pregnant women over 35. However, when researchers from the University of Nottingham in the United Kingdom looked at older, first-time moms who had labor induced during the 39th week of pregnancy, they found no greater risk of cesarean section or negative health effects.
"We were fairly surprised by our main result in that overall there was no significant effect on the rate of cesarean section in the group of mums who were induced at 39 weeks. Our trial was not set up to test induction as a way of avoiding stillbirth but it does prove the safety of performing a much larger trial to test this further," professor of obstetrics and gynecology at the University of Nottingham, Jim Thornton, said. "Some people say why not just induce everyone at 39 weeks and prevent some stillbirths. Others say that would medicalise many normal pregnancies, increase intervention rates and may have long term unintended harms. Ours is the first clinical trial to provide some hard evidence to help decision-making among doctors and older first-time mothers-to-be. The results support the 'induce more women' advocates, although there are still reasons for caution."
During the study, researchers randomly assigned over 600 pregnant women to have induced labor at 39 weeks or to receive another form of expectant care. To induce labor, researchers used an IV hormone drip that presses against the wall of the vagina or urethra. Those who received expectant care waited until labor naturally took place or a medical condition developed in which a cesarean section or vacuum-assisted delivery was necessary.
"I'm really encouraged by the results of the study, especially as it has covered such a difficult subject and area that isn't easy to suggest studies or research without creating more angst or worry among future parents," lay member of the research team, Chris Wild Smith, said. "I really hope the work can generate more discussion to the clinical approach and how to address risk groups. I do hope for all our stillborn children that the evidence will avoid more families going through the traumatic pain and hurt that we endured."
The study is published today in the New England Journal of Medicine.
