Induction of labour at term compared with expectant management in women
over 40 years of age: a retrospective study.
Objective To compare maternal and neonatal outcomes of induction of
labour at term to those of expectant management in women over 40 years
of age. Design Retrospective cohort study. Setting Data were derived
from the Hospital Álvaro Cunqueiro birth cohort (Vigo). Population Women
at ≧40 years of age and ≥39 weeks of gestation that delivered from 1
January 2012 to 31 December 2017. Methods Women were classified into two
groups: expectant management group (women who delivered from 1 January
2012 to 31 December 2014) and nonmedically indicated induction of labour
group (women who delivered from 1 January 2015 to 31 December 2017).
These two groups were described and compared. Main outcome measures The
primary outcome was the route of delivery. Perinatal results were also
studied. Results There was a total of 603 pregnant women in the
expectant management group compared to 634 women in the induction group.
The rate of cesarean section did not increase in the maternal age-based
labour induction group compared to the expectant management group.
Subgroup analysis did not demonstrate an increased risk by parity. Women
in the expectant management group were more likely to require neonatal
intensive care unit admission and need pediatric support. Conclusion
Compared to expectant management, induction of labour at 39 weeks of
gestation results in significantly better neonatal outcomes without
increasing the cesarean section rates in older women. Tweetable abstract
Induction of labour in women over 40 years of age associates better
perinatal outcomes without increasing the rate of caesarean sections.