Single indications of induction of labor with prostaglandins and risk of cesarean delivery: a retrospective cohort study.

ABSTRACT

AIM: To determine the risk of cesarean delivery after induction of labor with prostaglandins and to establish if this is influenced by a single indication of induction of labor or any intrinsic characteristic of the woman or labor. MATERIAL AND METHODS: A retrospective cohort study was carried out. Three hundred and twenty-four pregnant women who underwent pharmacological induction of labor with prostaglandins were divided into nine groups through indication of labor induction. Statistical analysis was assessed with the Kolmogorov-Smirnov test to assess the normal distribution of variables, Kruskal-Wallis test for comparisons of non-parametric continuous variables, univariate analysis to compare cesarean delivery rates and multivariate logistic regression. RESULTS: The risk of cesarean section was significantly higher only in prolonged pregnancy (OR = 1.98; 95% CI 1.18-3.34). Elective induction was associated with the lowest risk of cesarean section (OR = 0.46; 95% CI 0.26-0.81). Maternal age and was directly related (OR = 1.087; 95% CI 1.016-1.164), while parity (OR = 0.123; 95% CI 0.051-0.332), Bishop score (OR = 0.703; 95% CI 0.571-0.884), and duration of labor (OR = 0.995; 95% CI 0.993-0.998) were inversely correlated with cesarean delivery. CONCLUSION: Cesarean delivery rate is not significantly influenced by any indication of induction of labor with prostaglandins, except for prolonged pregnancy. Elective induction is associated with the lowest risk of cesarean section. Increasing maternal age, low parity, low Bishop score and low duration of labor are at higher risk of cesarean section.