title: Predictors of cesarean delivery in women undergoing labor induction with a Foley balloon.
abstract: OBJECTIVE
  To examine predictive characteristics for cesarean delivery (CD) in women undergoing labor induction with a Foley balloon (FB).
  
  
  METHODS
  A secondary analysis of a randomized, double-blind, control trial examining labor induction with a transcervical 30 mL or 60 mL FB. One-hundred ninety-nine women with term, vertex, singleton pregnancies and Bishop score < 5 were randomized to receive a transcervical 30 mL or 60 mL FB. Mode of delivery, labor complications and neonatal outcomes were recorded. A multivariable model was performed to determine predictive characteristics for CD.
  
  
  RESULTS
  Increasing maternal age (p = 0.04), nulliparity (p =0.002) and chorioamnionitis (p < 0.001) were significantly associated with an elevated risk for CD. Nulliparity was associated in an almost 4-fold increased CD risk (relative risk [RR]: 3.88; 95% confidence interval [CI]: 1.22-12.3). Women aged ≥ 40 years, had an almost 3-fold increased risk of CD as compared to women aged 20-29 (RR: 2.91; 95% CI: 1.36-6.19) years. Chorioamnionitis was associated with nearly a 2-fold increased risk for CD (RR: 1.87; 95% CI: 1.06-3.32). A gestational age of ≥ 41 weeks, prostaglandin use during induction and induction indication did not affect mode of delivery.
  
  
  CONCLUSIONS
  In patients undergoing labor induction with a FB, increasing maternal age, nulliparity and chorioamnionitis are associated with an elevated risk for CD.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington , Seattle, WA , USA .
authors.forename: Shani
authors.initials: S
authors.lastname: Delaney
authors.forename: Brian L
authors.initials: BL
authors.lastname: Shaffer
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Cheng
authors.forename: Juan
authors.initials: J
authors.lastname: Vargas
authors.forename: Teresa N
authors.initials: TN
authors.lastname: Sparks
authors.forename: Kathleen
authors.initials: K
authors.lastname: Paul
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects* / Q000379:methods; D016014:Linear Models; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
keywords: Bishop score; Foley catheter; cesarean delivery; labor induction; nulliparous