title: Low-risk pregnancy at 41 weeks: when should we induce labor?
abstract: OBJECTIVE
  To study the perinatal outcome according to whether labor was induced or not, when a low-risk pregnancy reached 41 weeks of gestation.
  
  
  METHODS
  A quasi-experimental study of 11492 low-risk singleton pregnancies was designed. A total of 1,721 patients (15.0%) women met the study criteria, were informed about the risks and benefits and gave their informed consent, of whom 629 (36.5%) were planned for induction soon after the 41 weeks (287-289 days).
  
  
  RESULTS
  An intention-to-treat analysis was performed. The proportion of small-for-gestational age babies was lower in the early-induced labor cohort (10.5% versus 15%; p = 0.008). This cohort showed an increased hospital stay (4.54 versus 3.80 days; p < 0.001), and a higher rate of requiring delivery by caesarean section (31.1% versus 19.8%;p < 0.001), including the need for caesarean section for failed induction (21.8% versus 11%;p < 0.001). Three stillbirths occurred in the group followed expectantly, whereas no stillbirths were seen in the early induction group.
  
  
  CONCLUSIONS
  Induction of labor for prolonged pregnancy in low-risk patients soon after the 41 weeks, reduces the proportion of small-for-gestational age babies, but increases the mean hospital stay as well as the need for delivery by caesarean section, including that for failed induction.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain. dorosl@salud.aragon.es
authors.forename: Daniel
authors.initials: D
authors.lastname: Oros
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Bejarano
authors.forename: Manolo Romero
authors.initials: MR
authors.lastname: Cardiel
authors.forename: Daniel
authors.initials: D
authors.lastname: Oros-Espinosa
authors.forename: Rafael
authors.initials: R
authors.lastname: Gonzalez de Agüero
authors.forename: Ernesto
authors.initials: E
authors.lastname: Fabre
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011273:Pregnancy, Prolonged / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012306:Risk; D013997:Time Factors; D055815:Young Adult