title: Complications of labor induction among multiparous women in a community-based hospital system.
abstract: OBJECTIVE
  The purpose of this study was to examine complications of labor induction compared to spontaneous labor in multiparas.
  
  
  METHODS
  This was a retrospective cohort study of multiparous women with live, singleton pregnancies at term, who had no contraindications to labor or labor induction. Cesarean delivery was the primary outcome.
  
  
  RESULTS
  Of the study subjects, 7208 experienced spontaneous labor, 2190 underwent labor induction with oxytocin, and 239 underwent labor induction requiring cervical ripening agents. Oxytocin-induced multiparas were 37% more likely to require cesarean compared to those with spontaneous labor (OR, 1.37; 95% CI, 1.10-1.71) and nearly 3 times more likely to undergo cesarean when cervical ripening agents were used (OR, 2.82; 95% CI, 1.84-4.53). Women requiring cervical ripening were also 10 times more likely to spend more than 12 hours in labor than those with spontaneous labor.
  
  
  CONCLUSIONS
  Multiparas undergoing labor induction are at increased risk for obstetric complications compared to spontaneous labor.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Orange, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Battista
authors.forename: Judith H
authors.initials: JH
authors.lastname: Chung
authors.forename: David C
authors.initials: DC
authors.lastname: Lagrew
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Wing
mesh_terms: D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D002585:Cesarean Section; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects* / Q000379:methods; D007743:Labor, Obstetric; D008297:Male; D010120:Oxytocics / Q000494:pharmacology / Q000627:therapeutic use*; D010121:Oxytocin / Q000494:pharmacology / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012102:Reproductive Control Agents / Q000627:therapeutic use; D012189:Retrospective Studies