Induced labor at 39 weeks linked to fewer c-sections, study finds

Inducing labor at 39 weeks is just as safe as waiting for naturally occurring labor and may actually lower the risk of cesarean section, according to a study published in The New England Journal of Medicine.

The study took place in 41 U.S. obstetrical centers, which are part of the National Institute of Child Health and Human Development's maternal-fetal medicine network. Researchers examined data on 3,062 women who had induced labor at week 39 of pregnancy and 3,044 women who were not induced.

Inducted pregnancy did not reduce the rate of perinatal death or lower severe birth complications in newborns; yet researchers saw a 35 percent decrease in hypertensive disorders among pregnant women in the induction group.

The study also challenges a large body of research suggesting induced labors increase the chance of C-section. Eighteen percent of women that were induced later underwent a C-section, compared to about 22 percent of women in the control group. Women who had an induced labor on average stayed in the hospital's labor and delivery unit six hours longer than the control group, but overall spent less time in the hospital. Based on this data, the study authors suggest induction at 39 weeks should be presented to healthy women delivering their first child, who already had an ultrasound earlier in their pregnancy to confirm their due date.  

"I think it’s going to have a very big impact on obstetric practice not just in the U.S., but around the world," Kate Walker, MD, clinical assistant professor in obstetrics and gynecology at England based-University of Nottingham who was not involved with the study, told STAT.

The American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine said the new body of research presents an additional delivery option for healthy women, according to STAT.

ACOG recommends elective induction after 41 weeks of pregnancy and does not advise the procedure before 39 weeks.

"ACOG and SMFM have reviewed the published results [and] determined that it is reasonable for obstetric care providers to offer an induction of labor to low-risk women after discussing the options thoroughly, as shared decision-making is a critical element," the medical groups said in a joint statement to STAT.

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