A comparison of maternal and perinatal outcomes with vaginal delivery: indicated induction versus spontaneous labor.

OBJECTIVE

To determine if there is a difference in the maternal and perinatal characteristics and outcomes of women undergoing a medically indicated labor induction and delivering vaginally compared to women in spontaneous labor delivering vaginally.

METHODS

This is a planned secondary analysis of previously published data with additional data collected for a case-control design. Maternal and perinatal characteristics and outcomes of women undergoing a medically indicated labor induction of labor and delivering vaginally were compared with the next woman who went into labor spontaneously and delivered vaginally.

RESULTS

There were 1097 women in the medically indicated labor group and 1096 women in the spontaneous labor group. The medically indicated induction group was younger ( < .0001), had less women of "other" race ( = .004), were of a lower gravidity and parity ( < .0001), had a lower Bishops' score on admission ( < .0001), had a greater proportion of umbilical arterial cord pH values <7.1 and <7.0 ( < .0001). Additionally, the induction group had longer first and second stages of labor ( < .0001). While the unadjusted rates of post-partum complications and NICU admission were higher in the medically indicated labor induction group, only cord gas pH <7.1 remained statistically significant after adjustment.

CONCLUSION

Even with successful vaginal delivery of a medically indicated induction of labor, the risk for adverse outcomes remains elevated.