Delivery Outcomes after Term Induction of Labor in Small-for-Gestational Age Fetuses.
ObjectiveThe objective of this study was to estimate the delivery outcomes after induction of labor (IOL) at term in patients with small-for-gestational age (SGA) fetuses.Study DesignA secondary analysis of a prospective cohort study of all term, singleton deliveries from 2010 to 2014. Patients who underwent an IOL for any indication were included. Delivery outcomes were compared between patients with and without SGA fetuses (defined as birth weight < 10th percentile for gestational age). Analysis was stratified by parity. Indication for cesarean was compared between the two groups for those who did not achieve vaginal delivery. Logistic regression was used to adjust for confounders.ResultsOf 3,787 patients who underwent an IOL, 644 patients had SGA fetuses and 3,143 were included in the non-SGA group. There was no significant difference in rate of successful vaginal delivery for patients with and without SGA fetuses (77.2 vs. 72.0% [adjusted odds ratio: 1.22, 95% confidence interval 1.00-1.50]). Of the patients who were delivered by cesarean, women with SGA fetuses were more likely to undergo cesarean for nonreassuring fetal status and less likely for arrest disorders than women without an SGA fetus.ConclusionTerm patients undergoing IOL with SGA fetuses are as likely to achieve a vaginal delivery as patients with non-SGA fetuses.
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Janine S
JS
Rhoades
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Roxane M
RM
Rampersad
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Methodius G
MG
Tuuli
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
George A
GA
Macones
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Alison G
AG
Cahill
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri.
Molly J
MJ
Stout
D000328:Adult; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007751:Labor, Induced / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008923:Missouri / Q000453:epidemiology; D015999:Multivariate Analysis; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D047929:Term Birth; D062606:Tertiary Care Centers; D016216:Ultrasonography, Prenatal; D055815:Young Adult