/ /

  • linkedin
  • Increase Font
  • Sharebar

    Labor induction vs expectant management in women over 35


    “Women have very polarized views about induction. Some are keen to be induced near their due date because they are tired of the pregnancy and/or worried about the risk of stillbirth. Others, however, feel that nature knows best and induction is meddlesome, usually unnecessary, and often leads to a cascade of interventions that may do more harm than good. Both groups have valid motivations, and we wanted to provide some hard data on the issues,” Dr Thornton told Contemporary OB/GYN.

    A total of 6455 women were evaluated for participation in the trial, of whom 3923 who were eligible declined to participate. Almost half of the latter group expressed a preference for labor induction or expectant management and their preference was overwhelmingly for expectant management (88%).

    The study protocol included a prespecified subgroup analysis of cesarean delivery rates according to maternal age, and its results also showed no statistically significant differences between labor induction and expectant management among women of any age subgroup.

    Secondary maternal outcomes looked at method of delivery other than cesarean section, onset of labor, indication for induction of labor, method of labor induction, indication for cesarean section, intrapartum complications, and postpartum complications. In addition, the mothers’ expectations and experience of childbirth were evaluated with completion of the Childbirth Experience Questionnaire 1 month after delivery.

    Secondary neonatal outcomes were live birth or still birth, birth weight, admission to a neonatal intensive care unit, birth trauma, direct trauma, and hypoxia.

    Discussing the study’s limitations, the investigators noted the findings regarding childbirth experience may not apply to women who prefer a particular strategy. In addition, the results for the other maternal outcomes and the neonatal outcomes may not be generalizable to older multiparous women or nulliparous women aged 35 or older with complicated pregnancies.



    1.  Walker KF, Bugg GJ, Macpherson, et al., for the 35/39 Trial Group. Randomized trial of labor induction in women 35 years of age or older. N Engl J Med. 2016;374(9):813–822.


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available


    Latest Tweets Follow