A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
The risk of cesarean delivery after labor induction among women with prior pregnancy complications: a subgroup analysis of the AFFIRM study
Tekijät: Leslie Skeith, Grégoire Le Gal, Johanna I. P. de Vries, Saskia Middeldorp, Mariëtte Goddijn, Risto Kaaja, Jean-Christophe Gris, Ida Martinelli, Ekkehard Schleußner, David Petroff, Nicole Langlois, Marc A. Rodger; for the AFFIRM investigators
Kustantaja: BMC
Julkaisuvuosi: 2019
Journal: BMC Pregnancy and Childbirth
Tietokannassa oleva lehden nimi: BMC PREGNANCY AND CHILDBIRTH
Lehden akronyymi: BMC PREGNANCY CHILDB
Artikkelin numero: ARTN 455
Vuosikerta: 19
Numero: 1
Sivujen määrä: 8
DOI: https://doi.org/10.1186/s12884-019-2615-x
Verkko-osoite: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2615-x
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/45138482
Background:To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction).MethodsThe AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor.
Results: There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p=0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p=0.01).
Conclusions: The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
