1 Texas Collaborative for Healthy Mothers and Babies (TCHMB) , Houston, Texas.
2 Population Health, Office of Health Affairs, Texas Collaborative for Healthy Mothers and Babies (TCHMB), University of Texas System , Austin, Texas.
J Womens Health (Larchmt). 2018 May;27(5):590-598. doi: 10.1089/jwh.2017.6598. Epub 2017 Dec 13.
Induction of labor (IOL) is increasingly common in the United States, yet characteristics associated with IOL among primiparous women delivering at term are not well understood.
Data from the Listening to Mothers III study, a survey of women aged 18-45 with singleton deliveries in U.S. hospitals in 2011-2012, were utilized. Weighted logistic regression models examined predictors of IOL among 924 primiparous women with term deliveries. Associations of maternal characteristics with delivery route (cesarean and vaginal delivery) were examined among primiparous women induced at term.
Four hundred twenty-three (45.8%) primiparous women with term deliveries underwent IOL; subjective reasons were reported by 53% of induced women. Women who were married (odds ratios [OR] = 1.8, 95% confidence intervals [CI] 1.2-2.9), felt pressure from a provider for IOL (OR = 3.5, 95% CI 2.0-6.2), and whose provider was concerned about the size of the baby (OR = 1.9, 95% CI 1.2-2.9) were significantly more likely to undergo IOL. Nearly 30% of primiparous women who underwent IOL at term had a cesarean delivery (CD). Among the induced women, those who were overweight/obese (OR = 4.9, 95% CI 2.5-10.0), felt pressure from a provider for CD (OR = 8.6, 95% CI 3.5-21.2), and whose provider suspected the baby might be getting large near end of pregnancy (OR = 2.7, 95% CI 1.1-7.0) were significantly more likely to have CD.
In this study, nearly half of the primiparous women with term deliveries underwent IOL, with a sizeable proportion reporting subjective reasons for induction. A better understanding of the characteristics associated with IOL at term may help reduce unnecessary interventions and, ultimately, primary CD.
在美国，引产（IOL）越来越常见，但对于足月初产妇进行 IOL 的相关特征，我们仍知之甚少。
我们利用了 2011-2012 年在美国医院分娩的 18-45 岁单胎产妇的 Listening to Mothers III 研究的数据。我们采用加权逻辑回归模型，对 924 例足月初产妇进行了 IOL 预测因素的分析。我们还在足月诱导分娩的初产妇中，对产妇特征与分娩方式（剖宫产和阴道分娩）的关系进行了研究。
423 例（45.8%）足月初产妇行 IOL；53%的诱导分娩产妇报告了主观原因。与未行 IOL 的产妇相比，已婚（比值比[OR] = 1.8，95%置信区间[CI] 1.2-2.9）、感到提供者有行 IOL 的压力（OR = 3.5，95% CI 2.0-6.2）和提供者担心胎儿大小（OR = 1.9，95% CI 1.2-2.9）的产妇更有可能行 IOL。近 30%的足月初产妇行 IOL 后行剖宫产（CD）。在诱导分娩的产妇中，超重/肥胖（OR = 4.9，95% CI 2.5-10.0）、感到提供者有行 CD 的压力（OR = 8.6，95% CI 3.5-21.2）和提供者怀疑胎儿在妊娠末期可能过大（OR = 2.7，95% CI 1.1-7.0）的产妇更有可能行 CD。
在这项研究中，近一半的足月初产妇行 IOL，其中相当一部分报告了诱导分娩的主观原因。更好地了解与足月 IOL 相关的特征，可能有助于减少不必要的干预，最终减少原发性 CD。
