Maternal and neonatal morbidities associated with cesarean delivery without labor compared with induction of labor around term
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ObjectiveWe aimed to compare the maternal and neonatal morbidities associated with elective cesarean delivery (CD) withoutlabor and those associated with induction of labor (IOL) at ≥38 weeks of gestation. MethodsThis retrospective observational study from 2013 to 2020 included singleton pregnancies in nulliparous women at ≥38weeks of gestation. Maternal and neonatal morbidities associated with elective CD without labor were comparedwith those associated with IOL. ResultsAltogether, 395 women were recruited. Among these, 326 underwent delivery through IOL, while 69 underwentelective CD. The elective CD group exhibited higher maternal age, lower gestational age at birth, and lower neonatalbirth weight than the IOL group (P<0.001). Moreover, the elective CD group exhibited longer hospital stay, higher rateof uterotonic agent usage, and lower rate of antibiotic usage after discharge. However, no differences were observedin postpartum bleeding, readmission, or number of outpatient visits (>3) after discharge between the groups. Perinatal morbidities were similar between the groups except the incidence of meconium-stained amniotic fluid. Elective CD exhibited similar rates of complications related to composite maternal morbidity when compared withIOL, but had a lower risk of complications related to composite neonatal morbidity (relative risk, 0.45; 95% confidenceinterval, 0.24-0.85). ConclusionElective CD and IOL had similar rates of composite maternal morbidity but the former exhibited some benefits againstobstetric wound infection. The elective CD group exhibited a decreased risk of composite neonatal morbidity despitelower gestational age at birth and higher maternal age.
Abstract
ObjectiveWe aimed to compare the maternal and neonatal morbidities associated with elective cesarean delivery (CD) withoutlabor and those associated with induction of labor (IOL) at ≥38 weeks of gestation. MethodsThis retrospective observational study from 2013 to 2020 included singleton pregnancies in nulliparous women at ≥38weeks of gestation. Maternal and neonatal morbidities associated with elective CD without labor were comparedwith those associated with IOL. ResultsAltogether, 395 women were recruited. Among these, 326 underwent delivery through IOL, while 69 underwentelective CD. The elective CD group exhibited higher maternal age, lower gestational age at birth, and lower neonatalbirth weight than the IOL group (P<0.001). Moreover, the elective CD group exhibited longer hospital stay, higher rateof uterotonic agent usage, and lower rate of antibiotic usage after discharge. However, no differences were observedin postpartum bleeding, readmission, or number of outpatient visits (>3) after discharge between the groups. Perinatal morbidities were similar between the groups except the incidence of meconium-stained amniotic fluid. Elective CD exhibited similar rates of complications related to composite maternal morbidity when compared withIOL, but had a lower risk of complications related to composite neonatal morbidity (relative risk, 0.45; 95% confidenceinterval, 0.24-0.85). ConclusionElective CD and IOL had similar rates of composite maternal morbidity but the former exhibited some benefits againstobstetric wound infection. The elective CD group exhibited a decreased risk of composite neonatal morbidity despitelower gestational age at birth and higher maternal age.
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