Factors and outcomes associated with the induction of labour in Latin America.
OBJECTIVE
To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America.


METHODS
Analysis of the 2005 WHO global survey database.


METHODS
Eight selected Latin American countries.


METHODS
All women who gave birth during the study period in 120 participating institutions.


METHODS
Bivariate and multivariate analyses.


METHODS
Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes.


RESULTS
Of the 97,095 deliveries included in the survey, 11,077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay>7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding.


CONCLUSIONS
In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.
Guerra
G V
GV
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil.
Cecatti
J G
JG
Souza
J P
JP
Faúndes
A
A
Morais
S S
SS
Gülmezoglu
A M
AM
Parpinelli
M A
MA
Passini
R
R
Carroli
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003422:Critical Care / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D007843:Latin America / Q000453:epidemiology; D008423:Maternal Age; D010502:Perineum / Q000293:injuries; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000628:therapy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult