TABLE 4.
Frequency of obstetric/neonatal events for nulliparous individuals who experienced IOL versus EM (inclusive) in two academic midwifery settings
| 39 weeks |
40 weeks |
41 weeks |
||||
|---|---|---|---|---|---|---|
| IOL |
EM 39 |
IOL |
EM 40 |
IOL |
EM 41 |
|
| n = 186 | n = 3266 | n = 214 | n = 2250 | n = 452 | n = 709 | |
| Rationale for labor induction (may have more than one rationale) | ||||||
| Prelabor rupture of membranes | 63 (33.8) | 119 (3.6) | 63 (29.4) | 56 (2.5) | 50 (11.1) | 6 (0.8) |
| Elective postdates | 0 (0.0) | 208 (6.3) | 8 (3.7) | 200 (8.9) | 153 (33.8) | 47 (6.6) |
| Medical or obstetric risks/conditions | 88 (47.3) | 356 (10.9) | 90 (42.1) | 266 (11.8) | 189 (41.8) | 77 (10.9) |
| Advanced maternal age | 3 (1.6) | 28 (0.9) | 10 (4.7) | 18 (0.8) | 12 (0.4) | 6 (0.8) |
| Social/other | 12 (6.4) | 24 (0.7) | 15 (7.0) | 9 (0.4) | 9 (1.9) | 0 (0.0) |
| None of the above/missing rationale | 34 (18.2) | 2772 (84.8) | 55 (25.7) | 1915 (85.1) | 55 (12.2) | 49 (6.9) |
| Neuraxial analgesia | 120 (71.9) | 1710 (60.4)* | 135 (75.8) | 1226 (62.0)* | 291 (75.7) | 397 (62.2)* |
| HTN disorders | 63 (34.4) | 209 (6.4)* | 47 (23.2) | 123 (5.5)* | 51 (11.3) | 35 (4.9)* |
| Suspected IAI | 11 (8.5) | 169 (6.7) | 13 (8.3) | 132 (7.5) | 33 (9.8) | 53 (9.2) |
| Augmentation of spontaneous labor | n/a | 956 (39.1) | n/a | 689 (41.8) | n/a | 268 (47.4) |
| Instrument-assisted vaginal birtha | 5 (3.5) | 115 (4.4) | 8 (4.8) | 80 (4.6) | 14 (4.7) | 26 (5.0) |
| Episiotomya | 6 (4.2) | 123 (4.7) | 5 (3.0) | 93 (5.4) | 17 (5.7) | 32 (6.2) |
| 3rd/4th-degree lacerationa | 3 (2.1) | 182 (7.0)* | 11 (6.3) | 129 (7.5) | 21 (7.1) | 37 (7.2) |
| Postpartum hemorrhageb | 16 (9.5) | 267 (8.9) | 14 (7.1) | 211 (10.3) | 51 (13.0) | 90 (14.1) |
| Blood transfusion | 4 (2.6) | 35 (1.2) | 4 (2.3) | 27 (1.3) | 4 (1.0) | 11 (1.7) |
| Macrosomiac | 13 (6.9) | 479 (14.7)* | 29 (13.6) | 402 (17.8) | 97 (21.5) | 161 (22.7) |
| Shoulder dystociaa | 3 (2.1) | 65 (2.5) | 6 (3.9) | 46 (2.7) | 13 (4.4) | 15 (2.9) |
| NICU admission | 8 (4.4) | 151 (4.7) | 10 (4.8) | 114 (5.1) | 24 (5.4) | 40 (5.7) |
| Composite neonatal outcome | 8 (4.3) | 157 (4.8) | 14 (5.1) | 119 (5.3) | 25 (5.5) | 43 (6.1) |
Note: Composite outcome =any of the following NICU admission, meconium aspiration, stillbirth, perinatal death.
Suspected IAI =diagnosis of maternal fever during or after labor or intra-amniotic infection during labor.
Abbreviations: HTN, hypertensive; IAI, intra-amniotic infection; NICU, neonatal intensive care unit.
Missing data: 535 on epidural variable.
Limited to vaginal birth.
Defined as 1000 mL or higher blood loss. Data for exclusive EM rates versus IOL were significant in the 40th and the 41st weeks (13.7% and 20.7%, respectively, P = 0.01).
Data for macrosomia with exclusive EM were significant at 39th week = 17.4%, P < 0.001; at 40th week = 22.2%, P < 0.004; and at 41st week = 32.7%, P = 0.002.
sig < 0.05.