Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks' Gestation or Longer

Tetsuya Kawakita; Katherine Bowers

doi:10.1055/s-0037-1606185

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(01): 095-102
DOI: 10.1055/s-0037-1606185

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks' Gestation or Longer

Authors

Tetsuya Kawakita

¹Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
Katherine Bowers

²Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

Abstract

Objective This study aims to compare outcomes of induction with planned cesarean in women with preeclampsia.

Study Design A retrospective cohort study, including women with singleton pregnancies, preeclampsia (mild, severe, and superimposed), and without previous cesarean at ≥ 34 weeks' gestation was conducted. Outcomes included primary outcome (intensive care unit [ICU] admission, thromboembolism, transfusion, and hysterectomy), composite severe neonatal outcome (asphyxia, arterial cord pH < 7.0, hypoxic–ischemic encephalopathy, and 5-minute Apgar score < 5), neonatal ICU (NICU) admission, transient tachypnea of newborn (TTN), and respiratory distress syndrome (RDS). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, controlling for confounders.

Results Of 5,506 women with preeclampsia at ≥ 34 weeks' gestation, 5,104 (92.7%) women underwent induction. Induction compared with planned cesarean was not associated with an increased risk of the primary outcome but was related to increased risks of ICU admission (aOR: 3.29; 95% CI: 1.02–10.64), and linked to decreased risks of composite neonatal outcome (aOR: 0.32; 95% CI: 0.10–0.99), NICU admission (aOR: 0.60; 95% CI: 0.43–0.84), TTN (aOR: 0.38; 95% CI: 0.22–0.64), and RDS (aOR: 0.44; 95% CI: 0.22–0.86).

Conclusion Induction was not associated with an increased risk of the primary outcome but was associated with an increased risk of ICU admission and decreased risks of neonatal outcomes.

Keywords

cesarean delivery - induction of labor - intensive care unit - preeclampsia

Full Text

References

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