The risk of newborn death in late-term pregnancies may be lower if labor is induced rather than taking a wait-and-see approach, a new study suggests.
It's widely believed that mothers and babies have an increased risk of problems at or beyond 42 weeks of pregnancy. (A normal-term pregnancy is 40 weeks.) Some studies have suggested that inducing labor at or after 41 weeks reduces those risks, but there is no consensus on managing healthy pregnancies that last more than 41 weeks, according to background information about the study.
The researchers were led by Ulla-Britt Wennerholm, an associate professor in obstetrics and gynecology at the University of Gothenburg's Sahlgrenska Academy in Sweden. They looked at more than 2,700 Swedish women, average age 31, with an uncomplicated, single pregnancy. They were randomly assigned to induced labor at 41 weeks or wait and see (expectant management) until induced labor at 42 weeks if necessary.
Rates of death and complications such as breathing problems, pneumonia and sepsis were not statistically different between the two groups: 2.4ő in the induced labor group and 2.2% in the wait-and-see group.
Other outcomes, such as cesarean section birth and mothers' health after giving birth, were also similar in the two groups, according to the study published in the journal BMJ.
However, it found that six babies in the wait-and-see group died, compared with none in the induced labor group, leading to an early halt of the study. For every 230 women induced at 41 weeks, one newborn death would be prevented, the researchers concluded.
They said women with low-risk pregnancies "should be informed of the risk profile of induction of labor versus expectant management and offered induction of labor no later than at 41 full weeks. This could be one [of few] interventions that reduces stillbirth."
Labor induction at 41 weeks "looks like the safer option for women and their babies," Sara Kenyon, a professor at the University of Birmingham in England, and colleagues wrote in an accompanying editorial.
It's important to give pregnant women a choice, according to the editorial authors. "Clear information about available options should be accessible to all pregnant women, enabling them to make fully informed and timely decisions," they wrote.
Source: BMJ, news release, Nov. 20, 2019.
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