Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Sci Rep. 2023 Sep 22;13(1):15830. doi: 10.1038/s41598-023-42413-6.
The rate of labor induction has increased in recent years. The results of previously conducted studies examining associations between elective induction of labor (IOL) and neonatal outcomes have been contradictory. The aim of this study was to examine the intrinsic neonatal risks following IOL. We conducted a population-based cohort study, including all women with recorded low-risk singleton pregnancies at a gestational age between 37 + 0 and 41 + 6 weeks in Sweden from 1999 to 2017. Data were collected from the Swedish Medical Birth register. Two study groups were compared-the elective induction group with the spontaneous labor onset group. The results showed that the rate of elective IOL increased from 7.2% in 1999 to 16.4% in 2017. Elective IOL was associated with a higher OR for chorioamnionitis, bacterial sepsis, intracranial hemorrhage, assisted ventilation, hyperbilirubinemia, APGAR < 7 at 5 min, and neonatal seizures compared to deliveries with spontaneous labor onset. Regarding mortality outcomes, no significant differences were shown between the groups for either early term or full-term deliveries. We conclude that IOL is associated with neonatal complications, although causality could not be established in this observational study. It is important to be aware of the increased risk and perform IOL with caution.
近年来，引产率有所增加。此前关于选择性引产（IOL）与新生儿结局之间关联的研究结果存在矛盾。本研究旨在探讨 IOL 后新生儿内在风险。我们进行了一项基于人群的队列研究，纳入了瑞典 1999 年至 2017 年间所有记录在案的低危单胎妊娠且孕龄在 37+0 至 41+6 周的孕妇。数据来自瑞典医疗出生登记处。我们比较了两组研究对象，即选择性引产组和自发性临产组。结果显示，1999 年至 2017 年，选择性 IOL 的比率从 7.2%增加到 16.4%。与自发性临产分娩相比，选择性 IOL 与绒毛膜羊膜炎、细菌性败血症、颅内出血、辅助通气、高胆红素血症、5 分钟时 APGAR<7 及新生儿癫痫的风险比（OR）更高。在死亡率方面，对于早期足月产和足月产，两组之间没有显著差异。我们的结论是，IOL 与新生儿并发症相关，尽管在这项观察性研究中无法确定因果关系。需要注意的是，IOL 存在风险增加，需要谨慎进行。
