title: Effect of fetal gender on induction of labor failure rates.
abstract: OBJECTIVE
  To evaluate gender effect on induction of labor (IoL) failure rates stratified by indication to delivery.
  
  
  METHODS
  Retrospective cohort analysis of singleton pregnancies 34-42 weeks undergoing cervical ripening using controlled-release PGE2 vaginal insert. IoL Indications were divided into: (1) maternal; (2) hypertensive disorders; (3) premature rupture of membrane or (4) fetal (growth abnormalities, oligohydramnios, postdate, etc,). IoL failure was defined as: (1) Bishop-score ≤7 after 24 hours of PGE2; (2) cesarean delivery due to failed induction; (3) fetal distress followed by PGE2 removal and emergent cesarean. IoL failure rates were stratified by neonatal gender and indication to induction. Logistic regression analysis was utilized to control outcomes to potential confounders.
  
  
  RESULTS
  Overall, 1062 pregnancies were included - 521 (49%) had male fetuses. IoL indications did not differ by gender. IoL failure rate was 20.1% (213/1062) - 76% for unfavorable Bishop-score after PGE2 removal; 5.2% for failed induction and 18.8% for fetal-distress while on PGE2. Overall, 14.3% delivered by cesarean section. There were no differences in IoL failure as a group or by indications to induction stratified by fetal gender (21.7% vs. 18.5%, male vs. females, p < 0.05).
  
  
  CONCLUSIONS
  IoL failure rate is not affected by fetal gender regardless of indication to induction.
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Rony
authors.initials: R
authors.lastname: Chen
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Aviram
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.affiliation: a Helen Schneider Hospital for Women, Rabin Medical Center , Petach-Tikva , Israel.|b Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
mesh_terms: D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D015331:Cohort Studies; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D005333:Fetus / Q000502:physiology*; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012737:Sex Factors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D015232:Dinoprostone
keywords: Failed induction; cesarean section; fetal gender; induction of labor