title: Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials.
abstract: Several randomized controlled trials (RCTs) compared induction of labour with expectant management in non-diabetic women with suspected fetal macrosomia.
  
  
  
  To evaluate the effects of labour induction for suspected fetal macrosomia.
  
  
  
  Literature search in electronic databases.
  
  
  
  We included all RCTs of suspected fetal macrosomia comparing labour induction with expectant management in term pregnancy.
  
  
  
  The primary outcome was the incidence of caesarean delivery.
  
  
  
  Four RCTs, including 1190 non-diabetic women with suspected fetal macrosomia at term, were analysed. Pooled data did not show a significant difference in incidence of caesarean delivery [relative risk (RR) 0.91, 95% confidence interval (CI) 0.76-1.09], operative and spontaneous vaginal delivery, shoulder dystocia, intracranial haemorrhage, brachial plexus palsy, Apgar score <7 at 5 min, cord blood pH <7, and mean birth weight comparing women who received induction of labour with those who were managed expectantly. The induction group had a significantly lower time to delivery (mean difference -7.55 days, 95% CI -8.20 to -6.89), lower rate of birth weight ≥4000 g (RR 0.50, 95% CI 0.42-0.59) and ≥4500 g (RR 0.21, 95% CI 0.11-0.39), and lower incidence of fetal fractures (RR 0.17, 95% CI 0.03-0.79) compared with expectant management group.
  
  
  
  Induction of labour ≥38 weeks for suspected fetal macrosomia is associated with a significant decrease in fetal fractures, and therefore can be considered as a reasonable option. TWEETABLE ABSTRACT: #Induction of labour for #macrosomia improves neonatal outcome.
authors.affiliation: Department of Health Science, Division of Pediatrics, Obstetrics and Gynecology, Careggi Hospital University of Florence, Florence, Italy.
authors.forename: E R
authors.initials: ER
authors.lastname: Magro-Malosso
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Saccone
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Navathe
authors.affiliation: Department of Health Science, Division of Pediatrics, Obstetrics and Gynecology, Careggi Hospital University of Florence, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Tommaso
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: V
authors.initials: V
authors.lastname: Berghella
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005320:Fetal Macrosomia / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D047929:Term Birth; D057832:Watchful Waiting / Q000379:methods*
keywords: Caesarean; expectant management; induction; macrosomia; non-diabetic; shoulder dystocia