Trends in labor induction indications: A 20-year population-based study.

Autor: Swift EM; Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland.; Reykjavik Birth Center, Reykjavik, Iceland., Gunnarsdottir J; Faculty of Medicine, Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland.; Department of Obstetrics and Gynecology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.; Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Zoega H; Faculty of Medicine, Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland.; Faculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, Australia., Bjarnadottir RI; Department of Obstetrics and Gynecology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.; Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Steingrimsdottir T; Department of Obstetrics and Gynecology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.; Faculty of Medicine, University of Iceland, Reykjavik, Iceland., Einarsdottir K; Faculty of Medicine, Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
Jazyk: angličtina
Zdroj: Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2022 Dec; Vol. 101 (12), pp. 1422-1430. Date of Electronic Publication: 2022 Sep 16.
DOI: 10.1111/aogs.14447
Abstrakt: Introduction: Use of labor induction has increased rapidly in most middle- and high-income countries over the past decade. The reasons for the stark rise in labor induction are largely unknown. We aimed to assess the extent to which the rising rate of labor induction is explained by changes in rates of underlying indications over time.
Material and Methods: The study was based on nationwide data from the Icelandic Medical Birth Register on 85 620 singleton births from 1997 to 2018. The rate of labor induction and indications for induction was calculated for all singleton births in 1997-2018. Change over time was expressed as relative risk (RR), using Poisson regression with 95% confidence intervals (CI) adjusted for maternal characteristics and indications for labor induction.
Results: The crude rate of labor induction rose from 12.5% in 1997-2001 to 23.9% in 2014-2018 (crude RR = 1.91, 95% CI 1.81-2.01). While adjusting for maternal characteristics had little impact, adjusting additionally for labor induction indications lowered the RR to 1.43 (95% CI 1.35-1.51). Induction was increasingly indicated from 1997-2001 to 2014-2018 by gestational diabetes (2.4%-16.5%), hypertensive disorders (7.0%-11.1%), prolonged pregnancy (16.2%-23.7%), concerns for maternal wellbeing (3.2%-6.9%) and maternal age (0.5%-1.2%). No indication was registered for 9.2% of inductions in 2014-2018 compared with 16.3% in 1997-2001.
Conclusions: Our results show that the increase in labor induction over the study period is largely explained by an increase in various underlying conditions indicating labor induction. However, indications for 9.2% of labor inductions remain unexplained and warrant further investigation.
(© 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)
Databáze: MEDLINE
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