Department of Obstetrics, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.
Eur Rev Med Pharmacol Sci. 2022 Aug;26(16):5918-5925. doi: 10.26355/eurrev_202208_29531.
The aim of the study was to investigate the effect of induction of labor on maternal and fetal outcomes.
This retrospective case-control study included 4386 pregnant women with low-risk singleton pregnancies who underwent regular prenatal examination and successful vaginal delivery at ≥41 weeks and 0 days of gestation in Fujian Maternal and Child Health Hospital between January 2014 and December 2018. Clinical data of women were retrospectively divided into the induction of labor group (2007 cases) and spontaneous onset of labor group (2361 cases) based on the mode of labor initiation. Two-sample independent t-test and χ2 tests were used to analyze the differences in clinical characteristics, such as maternal age and parity between the two groups.
The induction of the labor group had a significantly longer total duration of labor (9.37±5.37 vs. 8.82±5.13 h; p<0.001), more postpartum blood loss (219.18±188.32 vs. 199.95±124.69 mL; p=0.01) and a significantly higher incidence of severe postpartum hemorrhage (PPH) comparing to the spontaneous onset of labor group [0.8% (16/2007) vs. 0.33% (8/2361); p=0.041]. However, no significant difference was found in the neonatal outcomes. After adjusting for age, induction of labor in nulliparous women was more likely to lead to PPH than the spontaneous onset of labor [2.74% (55/2007) vs. 1.65% (39/2361); odds ratio=1.557; 95% confidence interval: 1.039-2.332; p<0.05].
Induction of labor increases the duration of labor and postpartum blood loss, especially in primary parturient, leading to an increased risk of PPH. This increase may be related to the overall higher duration of labor, associated with IOL. Therefore, low-risk nulliparous women should try to avoid induction of labor without medical indications.
本研究旨在探讨引产对母婴结局的影响。
本回顾性病例对照研究纳入了 2014 年 1 月至 2018 年 12 月在福建省妇幼保健院接受定期产前检查并于≥41 周+0 天且单胎顺产的 4386 例低危孕妇。根据分娩发动方式，将孕妇的临床资料分为引产组（2007 例）和自然临产组（2361 例）。采用两独立样本 t 检验和 χ2检验分析两组产妇年龄、产次等临床特征的差异。
引产组总产程（9.37±5.37 比 8.82±5.13 h；p<0.001）、产后出血量（219.18±188.32 比 199.95±124.69 mL；p=0.01）明显长于自然临产组，严重产后出血（PPH）发生率也明显高于自然临产组[0.8%（16/2007）比 0.33%（8/2361）；p=0.041]。两组新生儿结局比较差异无统计学意义。经年龄校正后，初产妇引产较自然临产更易发生 PPH[2.74%（55/2007）比 1.65%（39/2361）；比值比=1.557；95%置信区间：1.039~2.332；p<0.05]。
引产增加了产程和产后出血量，尤其在初产妇中，增加了 PPH 的风险。这种增加可能与 IOL 相关的整体产程延长有关。因此，无医学指征的低危初产妇应尽量避免引产。
