Which level of risk justifies routine induction of labor for healthy women?

AE Seijmonsbergen-Schermers, LL Peters, Bahareh Goodarzi, Monica Bekker, Marianne Prins, Maaike Stapert, Hannah G. Dahlen, Soo Downe, Arie Franx, Ank de Jonge

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Abstract

Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (and
their offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or even
uncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, an
artificially assisted conception, and even nulliparity are increasingly considered an indication for induction of
labor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of risk
justifies routine induction of labor for healthy women, only based on characteristics that are associated with
statistically significant small absolute risk differences, compared to others without these characteristics. This
commentary contributes to this debate by arguing why induction of labour should not routinely be offered to all
women where there is a small increase in absolute risk, and no any other medical risks or complications during
pregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates in
groups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.
Original languageEnglish
JournalSexual and Reproductive Healthcare
Publication statusPublished - Nov 2019

Cite this

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title = "Which level of risk justifies routine induction of labor for healthy women?",
abstract = "Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (andtheir offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or evenuncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, anartificially assisted conception, and even nulliparity are increasingly considered an indication for induction oflabor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of riskjustifies routine induction of labor for healthy women, only based on characteristics that are associated withstatistically significant small absolute risk differences, compared to others without these characteristics. Thiscommentary contributes to this debate by arguing why induction of labour should not routinely be offered to allwomen where there is a small increase in absolute risk, and no any other medical risks or complications duringpregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates ingroups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.",
author = "AE Seijmonsbergen-Schermers and LL Peters and Bahareh Goodarzi and Monica Bekker and Marianne Prins and Maaike Stapert and Dahlen, {Hannah G.} and Soo Downe and Arie Franx and {de Jonge}, Ank",
year = "2019",
month = "11",
language = "English",
journal = "Sexual and Reproductive Healthcare",
issn = "1877-5756",
publisher = "Elsevier",

}

Which level of risk justifies routine induction of labor for healthy women? / Seijmonsbergen-Schermers, AE; Peters, LL; Goodarzi, Bahareh; Bekker, Monica; Prins, Marianne; Stapert, Maaike ; Dahlen, Hannah G.; Downe, Soo; Franx, Arie; de Jonge, Ank.

In: Sexual and Reproductive Healthcare, 11.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Which level of risk justifies routine induction of labor for healthy women?

AU - Seijmonsbergen-Schermers, AE

AU - Peters, LL

AU - Goodarzi, Bahareh

AU - Bekker, Monica

AU - Prins, Marianne

AU - Stapert, Maaike

AU - Dahlen, Hannah G.

AU - Downe, Soo

AU - Franx, Arie

AU - de Jonge, Ank

PY - 2019/11

Y1 - 2019/11

N2 - Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (andtheir offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or evenuncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, anartificially assisted conception, and even nulliparity are increasingly considered an indication for induction oflabor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of riskjustifies routine induction of labor for healthy women, only based on characteristics that are associated withstatistically significant small absolute risk differences, compared to others without these characteristics. Thiscommentary contributes to this debate by arguing why induction of labour should not routinely be offered to allwomen where there is a small increase in absolute risk, and no any other medical risks or complications duringpregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates ingroups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.

AB - Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (andtheir offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or evenuncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, anartificially assisted conception, and even nulliparity are increasingly considered an indication for induction oflabor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of riskjustifies routine induction of labor for healthy women, only based on characteristics that are associated withstatistically significant small absolute risk differences, compared to others without these characteristics. Thiscommentary contributes to this debate by arguing why induction of labour should not routinely be offered to allwomen where there is a small increase in absolute risk, and no any other medical risks or complications duringpregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates ingroups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.

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