title: Single indications of induction of labor with prostaglandins and risk of cesarean delivery: a retrospective cohort study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy. gerber@unipg.it
authors: Sandro
authors: S
authors: Gerli
authors: Alessandro
authors: A
authors: Favilli
authors: Claudia
authors: C
authors: Giordano
authors: Vittorio
authors: V
authors: Bini
authors: Gian Carlo
authors: GC
authors: Di Renzo
mesh_terms: D000328:Adult; D000367:Age Factors; D020070:Cervical Ripening; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007751:Labor, Induced / Q000009:adverse effects; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D010120:Oxytocics / Q000009:adverse effects; D010298:Parity; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000453:epidemiology / Q000503:physiopathology*; D011453:Prostaglandins / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D010120:Oxytocics; D011453:Prostaglandins