title: Is preeclampsia associated with an increased risk of cesarean delivery if labor is induced?
abstract: OBJECTIVE
  To determine whether preeclampsia is associated with an increased risk of cesarean delivery if labor is induced.
  
  
  METHODS
  This retrospective cohort study of 3505 women >or=24 weeks gestation with singleton pregnancies undergoing labor induction compares cesarean delivery rates between preeclamptics and non-preeclamptics. Multivariable logistic regression analysis was used to control for potential confounders including unfavorable cervix (Bishop score <or=5), method of labor induction, maternal age, parity, gestational age, race/ethnicity, epidural use, medical insurance, and marital status.
  
  
  RESULTS
  Among term nulliparous women undergoing labor induction, preeclamptics had a higher cesarean delivery rate then non-preeclamptics (81/267, 30% vs. 363/1568, 23%; p = 0.011), as did preeclamptic compared with non-preeclamptic women who were term and multiparous (10/64, 16% vs. 55/900, 6%, p = 0.003). Preterm preeclamptics also had more cesarean deliveries compared with non-preeclamptics among nulliparous (48/164, 29% vs. 16/245, 7%; p < 0.001) and multiparous (13/72, 18% vs. 18/225, 8%; p = 0.015) women. In multivariable analysis, preeclampsia still conferred an increased risk of cesarean delivery if labor was induced (adjusted odd ratio = 1.90, 95% CI 1.45-2.48).
  
  
  CONCLUSIONS
  Women with preeclampsia undergoing labor induction had higher cesarean delivery rates compared with non-preeclamptics regardless of parity or gestational age. However, the majority of women with preeclampsia still had successful vaginal deliveries.
authors: Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California 94143-0132, USA. kimlh@obgyn.ucsf.edu
authors: Lena Heesun
authors: LH
authors: Kim
authors: Yvonne W
authors: YW
authors: Cheng
authors: Shani
authors: S
authors: Delaney
authors: Angie Child
authors: AC
authors: Jelin
authors: Aaron B
authors: AB
authors: Caughey
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data*; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult