Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks' Gestation or Longer

Abstract

Objective: This study aims to compare outcomes of induction with planned cesarean in women with preeclampsia.

Study design: A retrospective cohort study, including women with singleton pregnancies, preeclampsia (mild, severe, and superimposed), and without previous cesarean at ≥ 34 weeks' gestation was conducted. Outcomes included primary outcome (intensive care unit [ICU] admission, thromboembolism, transfusion, and hysterectomy), composite severe neonatal outcome (asphyxia, arterial cord pH < 7.0, hypoxic-ischemic encephalopathy, and 5-minute Apgar score < 5), neonatal ICU (NICU) admission, transient tachypnea of newborn (TTN), and respiratory distress syndrome (RDS). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, controlling for confounders.

Results: Of 5,506 women with preeclampsia at ≥ 34 weeks' gestation, 5,104 (92.7%) women underwent induction. Induction compared with planned cesarean was not associated with an increased risk of the primary outcome but was related to increased risks of ICU admission (aOR: 3.29; 95% CI: 1.02-10.64), and linked to decreased risks of composite neonatal outcome (aOR: 0.32; 95% CI: 0.10-0.99), NICU admission (aOR: 0.60; 95% CI: 0.43-0.84), TTN (aOR: 0.38; 95% CI: 0.22-0.64), and RDS (aOR: 0.44; 95% CI: 0.22-0.86).

Conclusion: Induction was not associated with an increased risk of the primary outcome but was associated with an increased risk of ICU admission and decreased risks of neonatal outcomes.