Induction of labor in a contemporary obstetric cohort
Open accessAbstract
Objective We sought to describe details of labor induction, including precursors and methods, and associated vaginal delivery rates.Study design This was a retrospective cohort study of 208,695 electronic medical records from 19 hospitals across the United States, 2002 through 2008.Results Induction occurred in 42.9% of nulliparas and 31.8% of multiparas and elective or no recorded indication for induction at term occurred in 35.5% and 44.1%, respectively. Elective induction at term in multiparas was highly successful (vaginal delivery 97%) compared to nulliparas (76.2%). For all precursors, cesarean delivery was more common in nulliparas in the latent compared to active phase of labor. Regardless of method, vaginal delivery rates were higher with a ripe vs unripe cervix, particularly for multiparas (86.6-100%).Conclusion Induction of labor was a common obstetric intervention. Selecting appropriate candidates and waiting longer for labor to progress into the active phase would make an impact on decreasing the national cesarean delivery rate.
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Enrollment criteria targeting seemingly healthy pregnancy increased the ability to observe spontaneously initiated birth, with a lower induction/pre-labor cesarean rate than the U.S. overall.
“our enrollment criteria, which targeted seemingly healthy pregnancy, did increase our ability to observe spontaneously-initiated birth, as the rate of induction of labor/pre-labor cesarean was 40% in our sample compared to an overall U.S. rate of greater than 50% (Laughon et al., 2012; Zhang et al., 2010).”
From Childhood stress and birth timing among African American women: cortisol as biological mediator (2017) · cites this paper as Laughon et al., 2012
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- Authors
- Laughon, S. K., Zhang, J., Grewal, J., Sundaram, R., Beaver, J., & Reddy, U. M.
- Affiliations
- National Institutes of Health (US)
- Shanghai Jiao Tong University (CN)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 206
- Issue
- 6
- Pages
- 486.e1-486.e9
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC3361637
- OpenAlex
- W2125188401
- Cited by
- 151
- References
- 24
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 13 · 2021: 12 · 2020: 13 · 2019: 15 · 2018: 10 · 2017: 25 · 2016: 7 · 2015: 10 · 2014: 8 · 2013: 9 · 2012: 1
- FWCI
- 10.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HHSN267200603425C)
- National Institutes of Health (HHSN267200603425C)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- labor induction, vaginal delivery rate, cesarean section, nulliparous women, multiparous women, cervical ripeness, latent phase of labor, active phase of labor
- MeSH terms
- Adolescent, Adult, Cesarean Section, Female, Humans, Labor Onset, Labor, Induced, Parity, Pregnancy, Pregnancy Complications, Retrospective Studies, United States, Cohort Studies, Elective Surgical Procedures, Cervical Ripening, Kaplan-Meier Estimate, Young Adult
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