Socioeconomic risk factors for labour induction in the United Kingdom

Carter, Sarah A.; Channon, Andrew Amos; Berrington, Ann

doi:10.1186/s12884-020-2840-3

Cited by 8 publications

(15 citation statements)

References 38 publications

(31 reference statements)

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“…While in the United Kingdom (UK) the recent maternity figures show an increase rate of 2.1% from the 29.4% in 2016-2017 to 31.6% in 2017-2018 [6] according to the Hospital Episode Statistics. This increase in induction rates in developed countries and particularly in the UK is attributed to improved diagnostic tools and better understanding of maternal medicine, advanced maternal age, and socioeconomic class variation [7][8][9]. The incidence of induction in Africa has been found to be below 10 percent in most settings.…”

Section: Epidemiologymentioning

confidence: 99%

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Induction of Labour

Nggada¹

2023

Current Challenges in Childbirth

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Induction of labour is one of the common obstetric interventions in the world with varied incidence rates between developed and developing countries. It is generally employed by obstetricians and physicians managing pregnant women when the risk of continuing such pregnancy is far greater than delivery at that said point. A detailed evaluation and indications for induction of labour should be done for every single woman. Methods of induction of labour could be pharmacological, mechanical or both; taking care to reduce or eliminate complications associated with this intervention. Decision for induction of labour should involve the most senior member of the team with a woman centered approach to care. Induction of labour carries multiple risks and complications compared with spontaneous onset of uterine contractions with increase tendency of operative vaginal delivery and caesarean section.

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Section: Epidemiologymentioning

confidence: 99%

“…Induction of Labour (IOL): This refers to the artificial initiation of uterine contractions before their spontaneous onset at or beyond the age of viability with the sole aim of delivery of the fetoplacental unit where the benefit of pregnancy termination exceeds its prolongation [1,2,7,10,11].…”

Section: Definition Of Termsmentioning

confidence: 99%

Induction of Labour

Nggada¹

2023

Current Challenges in Childbirth

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“…Several studies have explored the influence of maternal and fetal risk factors on the decision to induce 2 4 12–17 or augment labour. 18 19 These studies primarily focused on individual maternal indications such as hypertension and diabetes in pregnancy, with little consideration given to wider maternal and fetal factors for a more comprehensive understanding of the decision-making process.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of studies are also limited to Western countries (i.e. Belgium, Canada, United Kingdom, United States of America and Poland) 12–15 17 19 , while other studies were performed by continents (i.e. Latin America, Africa and Asia) 2 4 16 rather than in individual countries except for one in Nepal.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for labour induction and augmentation: a multicentre prospective cohort study in India

Cheng,

Zahir,

Solomi V

et al. 2023

Preprint

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OBJECTIVETo investigate clinical and non-clinical factors influencing labour induction and augmentation in pregnant women in India.DESIGNProspective cohort study of 9305 pregnant women.SETTING13 tertiary and community hospitals in six states across India.PARTICIPANTSWomen ≥18 years of age and planning a vaginal birth in the study hospital were recruited in the third trimester of pregnancy (≥28 weeks of gestation) and followed-up during labour and up to 48 hours of childbirth.MAIN OUTCOME MEASURESOutcomes were induction and augmentation of labour as per childbirth records. Maternal and fetal clinical conditions in current pregnancy were abstracted from medical records at recruitment and after childbirth, and classified based on guidelines to generate induction- related clinical indication groups: (i) ≥2 indications, (ii) one indication, (iii) no indication and (iv) contraindication. Non-clinical factors included self-reported maternal socio-demographic and lifestyle factors, and maternal medical and obstetric histories from medical records at recruitment. Multivariable logistic regression analyses were performed to identify independent associations of induction and augmentation of labour with the clinical and non- clinical factors.RESULTSAmong 9305 women, over two-fifth experienced labour induction (n=3936, 42.3%) and about a quarter had labour augmentation (n=2537, 27.3%). The majority who received labour induction/augmentation had at least one or more clinical indications, but around 34% did not have an indication. Compared with women with ≥2 indications, those with one (adjusted odds ratio 0.50, 95% confidence intervals 0.42 to 0.58) or no (0.24, 0.20 to 0.28) indication or with contraindications (0.12, 0.07 to 0.20) were less likely to be induced, adjusting for non-clinical characteristics. These associations were similar for augmentation of labour (0.71, 0.61 to 0.84, for one indication; 0.47, 0.39 to 0.55 for no indication; 0.17, 0.09 to 0.34 for contraindications). Several maternal demographic, healthcare utilization and socio-economic factors were independently associated with labour induction and augmentation.CONCLUSIONSDecisions about induction and augmentation of labour in our study population in India were largely guided by clinical recommendations but in nearly a third, there was no clinical indication based on guidelines. Further research is required to understand the complex influence of clinical need and socio-demographic factors on labour induction/augmentation in the context of risk and safety.What is already known on this topicSeveral established international and national guidelines recommend specific clinical indications and/or contraindications for induction of labour.Pregnant women are also given the option to decide on labour induction and/or augmentation after providing relevant informationWhat this study addsCompared to women with at least two clinical indications as per guidelines, those with one or no indication or with contraindications were less likely to be induced or augmented, independent of other non-clinical maternal characteristics.In a third of the participants, there was no clinical indication for induction/augmentation of labour based on guidelines.Several non-clinical factors including maternal demographic, healthcare utilization and socio-economic factors influenced the decision for labour induction and augmentation, which in turn could be due to women’s choice or clinicians’ unconscious bias and warrants further research.

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“…One-fifth of delivery in the UK is inducing due to safety concerns for the mother or fetus (4). Socioeconomics is one of the risk factors for labor induction in the United Kingdom (5). There is no data labor induction in Indonesia, but there were some data in Bahagia Hospital, Makassar, which were 22,9 percent of all delivery in 2017 and 5,9 percent in 2018 (6).…”

Section: Introductionmentioning

confidence: 99%

Labor-Induced Pregnancy Cases In Dr Soetomo General Hospital: A Descriptive Study

Firasy¹

2021

MHSJ

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Background: Labor induction is a procedure to stimulate uterine contractions during pregnancy before labor begins on its own to achieve a vaginal birth with medical or mechanical intervention to start the labor. This procedure aims to stimulate more extensive contraction in the uterus. The labor induction can reduce the caesarean rate. Prostaglandin E2 (PGE2) and misoprostol are the commonest medicine used to ripen the cervix in the Dr. Soetomo Hospital. Objective: Our study aim to evaluate the success rate of induction of labor patient. Methods: This study was a descriptive study using the medical record in 2018 in the Dr. Soetomo General Hospital, Surabaya. A total of 183 patient’s medical record data who underwent induced labor were used in this study. Inclusion criteria were the women with indication to deliver and have no cephalo-pelvic disproportion. Women with contraindication labor induction were excluded. Data was described using table and narrative approach. Results: The most range of gestational age was 21-36 weeks (53.01%) followed by 37-42 weeks (42.07%). There were 68 patients (37,1%) primigravida and 115 patients (62,8%) were multipara. The major induced labor was conducted with misoprostol (78.6%), and the most pelvic scores were 2 (58.46%) before underwent induced labor. Vertex delivery was the preferred mode of delivery after the induction of labor with 89 patients (48,62%). The labor induction failure followed with the caesarean operation were 27 patients (14,7%) and one patient (0,54%) with hysterotomy, most of them caused by failure to progress and fetal distress. There were 78 babies (43%) with the weight over 2500 g, 28 babies (31%) were over 2000 g, and the other was below 2000 g. A total of 84.71% with labor induction can be delivered vaginally, and It is a good number to reduce the rate of caesarean operations. Conclusion: This study concludes that misoprostol uses for the induction of labor than the other. Delivery abdominal is less percentage than the additional delivery finds that as a failure of induction of labor. The Labor induction success to delivered vaginally can reduce the rate of caesarean operation.

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Socioeconomic risk factors for labour induction in the United Kingdom

Cited by 8 publications

References 38 publications

Induction of Labour

Induction of Labour

Risk factors for labour induction and augmentation: a multicentre prospective cohort study in India

Labor-Induced Pregnancy Cases In Dr Soetomo General Hospital: A Descriptive Study

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