Inducing labor in older pregnant women does not raise the risk of Cesarean section delivery or other adverse events on both the mother and the baby, a new study found.
Cesarean Section Delivery In Older Women
In the UK, the percentage of Cesarean section delivery among pregnant women aged 35 years old and above is 38 percent. Women aged 40 and above have a higher rate of Cesarean section delivery at 50 percent. All of these women have never had a delivery in the past.
With these rates, induction of labor before the expected date of delivery is believed to be beneficial. This is because 38 weeks is the age of gestation associated with the lowest risk of death just before or after delivery.
The authors say that most experiments with induction of labor involve participants who have established complications such as diabetes and hypertension, among others.
"Trials of induction of labor in women of advanced maternal age are lacking," the researchers write.
Establishing The Truth
To investigate, the authors recruited 619 pregnant women who have never experienced delivering a baby in the past. The subjects were divided into two groups. The first group was induced to have labor at 39 weeks of pregnancy and the other one had normal prenatal care/expectant management past the 39th week of pregnancy.
The findings of the study show that there were no differences in both maternal and neonatal outcomes in both groups.
Serious adverse effects were noted in three percent of the induction group and 10 percent in the expectant-management group. However, most of the adverse effects were entailed in the predetermined secondary outcomes.
The most prevalent complication among mothers was excessive bleeding after delivery or postpartum hemorrhage. Postpartum hemorrhage may be defined as blood loss of more than 500 ml for normal vaginal delivery and more than 1,000 ml for Cesarean section delivery.
For the study, 95 and 90 participants in the induction group and expectant management group suffered from postpartum hemorrhage respectively.
Ultimately, there were no discrepancies in Cesarean section delivery risks even when the authors classified the women by age. A subgroup analysis did not reveal treatment differences related to age.
The study was published in the New England Journal of Medicine on Thursday, March 3.