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Inducing Labor Before 39 Weeks Gestation Increases Risk of Delivery Complications, Health Problems Among Infants, Study Says

Kaisernetwork.org Daily Reproductive Health Report
October 22, 2004

Women who have labor induced before the 39th week of pregnancy are at an increased risk for delivery-related complications and are more likely to deliver infants with respiratory and other health problems, according to a study presented at a recent national conference of obstetricians and gynecologists, the Salt Lake City Deseret Morning News reports (Collins, Salt Lake City Deseret Morning News, 10/20). Dr. Bryan Oshiro, medical director for the Women's and Newborn Program at Intermountain Health Care -- Utah's largest health provider -- and colleagues studied 85,000 births in Utah in 2002 and 2003, the Salt Lake Tribune reports. According to the study, 2.5% of infants born to women who were induced at 39 weeks gestation were admitted to the neonatal intensive care unit, compared with 6.7% of infants born to women induced at 37 weeks. In addition, only 0.25% of infants whose delivery was induced at 39 weeks required a ventilator to breathe, compared with 1.19% of infants born at 37 weeks (Hamilton, Salt Lake Tribune, 10/20). In addition, inducing labor earlier than 39 weeks can result in longer labor, an increased chance of needing a caesarean section and an increased chance of infection, according to the Morning News (Salt Lake City Deseret Morning News, 10/20).

Reasons To Induce Labor
There are valid medical reasons to induce labor, including the rupture of the amniotic sac, high blood pressure, serious infection, diabetes, retarded growth of the fetus or pregnancy that has extended more than 42 weeks, according to the Tribune. However, some women might want an induction for nonmedical reasons, such as discomfort or sleeplessness or to schedule the delivery to coincide with family members' visits or their doctor's schedule, according to Oshiro. However, data show that "there is a definite health advantage to the baby by waiting until it reaches 39 weeks (of) development," Oshiro said. IHC has seen a drop in complications and related costs since 2001, when it informally asked physicians to restrict inductions before 39 weeks gestation. Since 2001, the number of elective induced deliveries at IHC has dropped from 30% of all pregnancies -- which is the national average -- to 5%, the Tribune reports (Salt Lake Tribune, 10/20). IHC also has developed an education campaign for doctors and parents on the importance of waiting to induce if the labor is elective because research has shown that physicians who have not studied the issue believe it is not a problem to induce labor early (Salt Lake City Deseret Morning News, 10/20).

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