The risk of cesarean delivery after labor induction among women with prior pregnancy complications: a subgroup analysis of the AFFIRM study
Johanna I. P. de Vries; David Petroff; Leslie Skeith; Ekkehard Schleußner; Marc A. Rodger; for the AFFIRM investigators; Mariëtte Goddijn; Jean-Christophe Gris; Grégoire Le Gal; Saskia Middeldorp; Nicole Langlois; Risto Kaaja; Ida Martinelli
The risk of cesarean delivery after labor induction among women with prior pregnancy complications: a subgroup analysis of the AFFIRM study
Johanna I. P. de Vries
David Petroff
Leslie Skeith
Ekkehard Schleußner
Marc A. Rodger; for the AFFIRM investigators
Mariëtte Goddijn
Jean-Christophe Gris
Grégoire Le Gal
Saskia Middeldorp
Nicole Langlois
Risto Kaaja
Ida Martinelli
BMC
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042821016
https://urn.fi/URN:NBN:fi-fe2021042821016
Tiivistelmä
Background:To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction).MethodsThe AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor.
Results: There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p=0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p=0.01).
Conclusions: The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.
Kokoelmat
- Rinnakkaistallenteet [19207]