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Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials

Author

Listed:
  • Mårten Alkmark
  • Judit K J Keulen
  • Joep C Kortekaas
  • Christina Bergh
  • Jeroen van Dillen
  • Ruben G Duijnhoven
  • Henrik Hagberg
  • Ben Willem Mol
  • Mattias Molin
  • Joris A M van der Post
  • Sissel Saltvedt
  • Anna-Karin Wikström
  • Ulla-Britt Wennerholm
  • Esteriek de Miranda

Abstract

Background: The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. Several randomised controlled trials (RCTs) have assessed if induction of labour (IOL) in uncomplicated pregnancies at 41 weeks will improve perinatal outcomes. We performed an individual participant data meta-analysis (IPD-MA) on this subject. Methods and findings: We searched PubMed, Excerpta Medica dataBASE (Embase), The Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO on February 21, 2020 for RCTs comparing IOL at 41 weeks with expectant management until 42 weeks in women with uncomplicated pregnancies. Individual participant data (IPD) were sought from eligible RCTs. Primary outcome was a composite of severe adverse perinatal outcomes: mortality and severe neonatal morbidity. Additional outcomes included neonatal admission, mode of delivery, perineal lacerations, and postpartum haemorrhage. Prespecified subgroup analyses were conducted for parity (nulliparous/multiparous), maternal age (

Suggested Citation

  • Mårten Alkmark & Judit K J Keulen & Joep C Kortekaas & Christina Bergh & Jeroen van Dillen & Ruben G Duijnhoven & Henrik Hagberg & Ben Willem Mol & Mattias Molin & Joris A M van der Post & Sissel Salt, 2020. "Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials," PLOS Medicine, Public Library of Science, vol. 17(12), pages 1-25, December.
    • Handle: RePEc:plo:pmed00:1003436
    DOI: 10.1371/journal.pmed.1003436
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