Inducing labor at 39 weeks can reduce c-section rates, study says

Feb. 1 (UPI) -- If a healthy woman has labor induced in the 39th week of pregnancy, the need for a cesarean delivery is reduced, according to a new study.

The study results were presented at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas on Thursday and published in the January issue of the American Journal of Obstetrics and Gynecology.

The research presented was part of, "A Randomized Trial of Induction Versus Expectant Management," or ARRIVE, which was funded by the National Institute of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Although C-section can be life-saving, the procedure can also lead to increased infection, hysterectomy and placenta implantation abnormalities in future pregnancies, and respiratory illness in infants.

"Safe reduction of the primary cesarean is an important strategy in improving birth outcomes," said Dr. William Grobman, a professor of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine, said in a press release.

Cesarean delivery has increased dramatically in the United States from 22.7 percent of all births in the 1990s to 32.7 percent in 2013, according to the Centers for Disease Control and Prevention. In 2014, the Joint Commission's National Quality Core Measures for hospitals renewed objectives to reduce low-risk Cesarean rates.

"We have higher overall rates than are medically necessary," said Katy Kozhimannil, a women's health researcher at the University of Minnesota, told STAT in 2015 following the publication of a study suggesting c-sections are performed far too often in the United States.

Between March 2014 and August 2017, 6,106 first-time mothers participated in the randomized study at various hospitals.

In the study, 3,062 women had induced labor and 3,044 were assigned to expectant management, or waiting for labor to begin naturally and intervening if problems occur.

Cesarean delivery was less frequent in the induced labor group, at 19 percent, compared with the expectant management group, at 22 percent.

Women in the induced group were also less likely to experience pregnancy-related blood pressure disorders, such as preeclampsia and gestational hypertension -- they occurred in 9 percent of the induced group and 14 percent of the expectant management group.

In newborns, the need for respiratory support after three days was 3 percent in the induced group, but 4 percent in the expectant management group.

The Society for Maternal-Fetal Medicine currently recommends inducing labor for first-time mothers at 41 weeks, but elective induction at 39 weeks has become more common, hence the interest in safety and effects of opting for the procedure.

"SMFM will wait to evaluate the peer-reviewed publication of the ARRIVE Trial before providing any guidance or changes to our existing recommendations," said Dr. Alfred Abuhamad, president of the organization.