Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka
Abstract Objectives The World Health Organization recommends induction of labour (IOL) for low risk pregnancy from 41 + 0 gestational weeks (GW). Nevertheless, in Sri Lanka IOL at 40 GW is a common practice. This study compares maternal/newborn outcomes after IOL at 40 GW (IOL40) or 41 GW (IOL41) ve...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04800-1 |
| _version_ | 1818117136636182528 |
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| author | Hemantha Senanayake Ilaria Mariani Emanuelle Pessa Valente Monica Piccoli Benedetta Armocida Caterina Businelli Mohamed Rishard Benedetta Covi Marzia Lazzerini |
| author_facet | Hemantha Senanayake Ilaria Mariani Emanuelle Pessa Valente Monica Piccoli Benedetta Armocida Caterina Businelli Mohamed Rishard Benedetta Covi Marzia Lazzerini |
| author_sort | Hemantha Senanayake |
| collection | DOAJ |
| description | Abstract Objectives The World Health Organization recommends induction of labour (IOL) for low risk pregnancy from 41 + 0 gestational weeks (GW). Nevertheless, in Sri Lanka IOL at 40 GW is a common practice. This study compares maternal/newborn outcomes after IOL at 40 GW (IOL40) or 41 GW (IOL41) versus spontaneous onset of labour (SOL). Methods Data were extracted from the routine prospective individual patient database of the Soysa Teaching Hospital for Women, Colombo. IOL and SOL groups were compared using logistic regression. Results Of 13,670 deliveries, 2359 (17.4%) were singleton and low risk at 40 or 41 GW. Of these, 456 (19.3%) women underwent IOL40, 318 (13.5%) IOL41, and 1585 (67.2%) SOL. Both IOL40 and IOL41 were associated with an increased risk of any maternal/newborn negative outcomes (OR = 2.21, 95%CI = 1.75–2.77, p < 0.001 and OR = 1.91, 95%CI = 1.47–2.48, p < 0.001 respectively), maternal complications (OR = 2.18, 95%CI = 1.71–2.77, p < 0.001 and OR = 2.34, 95%CI = 1.78–3.07, p < 0.001 respectively) and caesarean section (OR = 2.75, 95%CI = 2.07–3.65, p < 0.001 and OR = 3.01, 95%CI = 2.21–4.12, p < 0.001 respectively). Results did not change in secondary and sensitivity analyses. Conclusions Both IOL groups were associated with higher risk of negative outcomes compared to SOL. Findings, potentially explained by selection bias, local IOL protocols and CS practices, are valuable for Sri Lanka, particularly given contradictory findings from other settings. |
| first_indexed | 2024-12-11T04:33:37Z |
| format | Article |
| id | doaj.art-a5013dbfe6584bbd900141e800dec642 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-11T04:33:37Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-a5013dbfe6584bbd900141e800dec6422022-12-22T01:20:48ZengBMCBMC Pregnancy and Childbirth1471-23932022-06-0122111010.1186/s12884-022-04800-1Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri LankaHemantha Senanayake0Ilaria Mariani1Emanuelle Pessa Valente2Monica Piccoli3Benedetta Armocida4Caterina Businelli5Mohamed Rishard6Benedetta Covi7Marzia Lazzerini8University Obstetrics Unit, De Soysa Hospital for WomenInstitute for Maternal and Child Health - IRCCS “Burlo Garofolo”, WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health - IRCCS “Burlo Garofolo”, WHO Collaborating Centre for Maternal and Child HealthDepartment of Obstetrics & Gynaecology, Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, National Institute of HealthDepartment of Obstetrics & Gynaecology, Institute for Maternal and Child Health - IRCCS “Burlo Garofolo”University Obstetrics Unit, De Soysa Hospital for WomenInstitute for Maternal and Child Health - IRCCS “Burlo Garofolo”, WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health - IRCCS “Burlo Garofolo”, WHO Collaborating Centre for Maternal and Child HealthAbstract Objectives The World Health Organization recommends induction of labour (IOL) for low risk pregnancy from 41 + 0 gestational weeks (GW). Nevertheless, in Sri Lanka IOL at 40 GW is a common practice. This study compares maternal/newborn outcomes after IOL at 40 GW (IOL40) or 41 GW (IOL41) versus spontaneous onset of labour (SOL). Methods Data were extracted from the routine prospective individual patient database of the Soysa Teaching Hospital for Women, Colombo. IOL and SOL groups were compared using logistic regression. Results Of 13,670 deliveries, 2359 (17.4%) were singleton and low risk at 40 or 41 GW. Of these, 456 (19.3%) women underwent IOL40, 318 (13.5%) IOL41, and 1585 (67.2%) SOL. Both IOL40 and IOL41 were associated with an increased risk of any maternal/newborn negative outcomes (OR = 2.21, 95%CI = 1.75–2.77, p < 0.001 and OR = 1.91, 95%CI = 1.47–2.48, p < 0.001 respectively), maternal complications (OR = 2.18, 95%CI = 1.71–2.77, p < 0.001 and OR = 2.34, 95%CI = 1.78–3.07, p < 0.001 respectively) and caesarean section (OR = 2.75, 95%CI = 2.07–3.65, p < 0.001 and OR = 3.01, 95%CI = 2.21–4.12, p < 0.001 respectively). Results did not change in secondary and sensitivity analyses. Conclusions Both IOL groups were associated with higher risk of negative outcomes compared to SOL. Findings, potentially explained by selection bias, local IOL protocols and CS practices, are valuable for Sri Lanka, particularly given contradictory findings from other settings.https://doi.org/10.1186/s12884-022-04800-1Induction of labourFull term pregnancyLate term pregnancyPregnancy outcomesLow risk pregnancies |
| spellingShingle | Hemantha Senanayake Ilaria Mariani Emanuelle Pessa Valente Monica Piccoli Benedetta Armocida Caterina Businelli Mohamed Rishard Benedetta Covi Marzia Lazzerini Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka BMC Pregnancy and Childbirth Induction of labour Full term pregnancy Late term pregnancy Pregnancy outcomes Low risk pregnancies |
| title | Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka |
| title_full | Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka |
| title_fullStr | Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka |
| title_full_unstemmed | Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka |
| title_short | Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka |
| title_sort | outcomes of induction versus spontaneous onset of labour at 40 and 41 gw findings from a prospective database sri lanka |
| topic | Induction of labour Full term pregnancy Late term pregnancy Pregnancy outcomes Low risk pregnancies |
| url | https://doi.org/10.1186/s12884-022-04800-1 |
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