Nicholson Sarah M, Hatt Susan, Kent Etaoin M, Geary Michael P, Dicker Patrick, Molphy Zara E, Flood Karen, Malone Fergal D
Rotunda Hospital, Dublin, Ireland.
Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
Int J Gynaecol Obstet. 2025 Apr;169(1):383-390. doi: 10.1002/ijgo.16054. Epub 2024 Nov 25.
Induction of labor (IOL) is a controversial topic in contemporary obstetric practice, with some suggesting that the increase in elective induction (eIOL) as a potential contributor to increasing cesarean delivery (CD) rates. The objectives of this single-center study were to examine the rates of IOL, trends in indications for IOL, and the contribution of IOL to the overall CD rate at one of Europe's largest obstetric hospitals.
This retrospective observational cohort study evaluated the outcomes of patients who were delivered following IOL from 2018 to 2022 inclusive at the largest obstetric hospital in Ireland.
A total of 36 938 women (16 155 nulliparous and 20 783 multiparous) were delivered during the 5-year study period, of whom 8072 nulliparous and 6343 multiparous women underwent IOL. There was a significant increase in rates of induction, increasing from 42% to 57% (P <0.001) in nulliparous women, and from 27% to 33% (P < 0.001) in multiparous women. The highest contributions to the hospital CD rate were from those being induced for 'fetal' (5%), spontaneous rupture of membranes ('SROM') (4%), and 'maternal' (4%) reasons, with the lowest CD rates in the eIOL category (<1%) in both groups.
Our data confirm that the rate of IOL is increasing. The contribution of maternal and fetal reasons for IOL to the overall CD rate may reflect increasing numbers of higher-risk pregnancies. Despite current controversy regarding the role of eIOL, our data do not confirm a significant contribution to either the overall IOL or CD rates in this center.
引产在当代产科实践中是一个有争议的话题，一些人认为选择性引产（eIOL）的增加可能是剖宫产（CD）率上升的一个潜在因素。本单中心研究的目的是在欧洲最大的产科医院之一，研究引产率、引产指征的趋势以及引产对总体剖宫产率的影响。
这项回顾性观察性队列研究评估了2018年至2022年期间在爱尔兰最大的产科医院接受引产的患者的结局。
在为期5年的研究期间，共有36938名女性分娩（16155名单胎产妇和20783名经产妇），其中8072名单胎产妇和6343名经产妇接受了引产。引产率显著上升，单胎产妇从42%升至57%（P<0.001），经产妇从27%升至33%（P<0.001）。对医院剖宫产率贡献最高的是因“胎儿”（5%）、胎膜早破（“SROM”，4%）和“母体”（4%）原因引产的患者，两组中eIOL类别（<1%）的剖宫产率最低。
我们的数据证实引产率在上升。引产的母体和胎儿原因对总体剖宫产率的影响可能反映了高危妊娠数量的增加。尽管目前关于eIOL的作用存在争议，但我们的数据并未证实其对该中心的总体引产率或剖宫产率有显著影响。
