Conclusions
In conclusion, our study demonstrates that in low-risk women induction
of labor at 39 weeks gestation is not associated with any adverse
effects on maternal or neonatal outcomes, but it is significantly
associated with both lower frequencies of maternal and neonatal
morbidity when compared to expectant management through 42 weeks. Thus,
avoiding or delaying the induction of labor at or after 39 weeks
gestation may not always be in the best interest of the mother nor the
neonate. Based on our study and supported by a growing body of
literature a careful discussion of current policies and a
reconsideration of current standard clinical protocols aimed at the
avoidance of induction of labor at 39 weeks gestation in low-risk women
seems warranted.
Acknowledgements : We would like to thank the National
Center for Health Statistics (NCHS) and Centers for Disease Control and
Prevention’s (CDC) Division of Vital Statistics for the creation and
maintenance of this freely accessible database.
Disclosures of interests: No conflicts of interest to
declare.
Contribution to Authorship: SC and RY planned the study
and obtained the necessary data. All authors (SCB, RY, MD, JR, SC)
contributed to the analysis of the data and interpretation of results.
SCB drafted the manuscript and all other authors assisted with editing
of the manuscript. All authors have accepted it in its final form.
Details of Ethics Approval: This study is a national
retrospective cohort analysis using data abstracted from the NCHS and
CDC’s Division of Vital Statistics database. The data is publicly
available and de-identified, therefore no patients were directly
involved and no ethical approval was required.
Funding : None