Will inducing low-risk women at 40 weeks improve the outcomes of mothers
and babies? A retrospective cohort, observational, single-centre study
Abstract
Objective We compared maternal and foetal outcomes between termination
gestational age at 40 0/7-40 6/7 and 41 0/7-41 6/7 weeks. Design
Retrospective cohort, observational, single-centre study. Setting
Jiangsu Province Hospital, China: January 2020-December 2020 Population
1569 low-risk pregnancies. Methods Maternal medical records and neonatal
delivery data were analysed retrospectively. Main outcome measures
Difference in adverse outcomes of mothers and babies between termination
gestational age at 40 0/7-40 6/7 and 41 0/7-41 6/7 weeks. Results The
study included 1569 pregnancies, with 1107 (70.6%) delivered at 40
0/7-40 6/7 weeks and 462 (29.4%) delivered at 41 0/7-41 6/7 weeks.
Intrapartum caesarean section (8% versus 16%, P<0.001),
meconium-stained amniotic fluid (13% versus 19%, P=0.004), episiotomy
(41% versus 49%, P=0.011), and macrosomia (13% versus 18%, P=0.026)
were significantly lower at 40 0/7-40 6/7 weeks. The premature rupture
of membranes rate(22% versus 12%, P<0.001), spontaneous
labour rate(54% versus 20%, P<0.001), vaginal delivery rate
of artificial rupture of membrane induction (83% versus 71%, P=0.006)
and balloon catheter combined with oxytocin induction (88% versus 79%,
P=0.049) were significantly higher at 40 0/7-40 6/7 weeks. Conclusions
Low-risk women who delivered at 40 0/7-40 6/7 weeks showed better
outcomes in terms of the mother’s and baby’s health, such as decreased
rates of intrapartum caesarean section, meconium-stained amniotic fluid,
episiotomy, and macrosomia, compared with those who delivered at 41
0/7-41 6/7 weeks. Tweetable abstract Induction at 40 weeks will decrease
adverse outcomes of mothers and babies.