The Effect of Ethnic Variation on the Success of Induced Labour in Nulliparous Women with Postdates Pregnancies

Abstract

Objective. To identify the potential effect of ethnic variation on the success of induction of labour in nulliparous women with postdates pregnancies. Study Design. This was an observational cohort study of women being induced for postdates pregnancies (≥41 weeks) between 2007 and 2013. Women induced for stillbirths and with multiple pregnancies were excluded. The primary objective was to identify the effect of ethnicity on the caesarean section (CS) delivery rates in this cohort of women. Results. 1,636 nulliparous women were identified with a mean age of 27.2 years. 95.8% of the women were of White ethnic origin, 2.6% were Asian, and 1.6% were of Black ethnic origin. The CS delivery rate was 24.4% in the total sample. Women of Black ethnic origin had a 3.26 times greater likelihood for CS in comparison to White women, after adjusting for maternal age, BMI, smoking, presence of meconium, use of epidural analgesia, fetal gender, birth weight, and head circumference (adjusted OR = 3.26; 95% CI: 1.31–8.08, p = 0.011). Conclusion. We have found that nulliparous women of Black ethnicity demonstrate an almost threefold increased risk of caesarean section delivery when induced for postdates pregnancy.

Maternal obesity and its association with the mode of delivery and the neonatal outcome in induced labour: Implications for midwifery practice

“…The main strength of our study was that it included a large sample of women that generated statistically significant results comparable to those referenced in the literature for other countries. Moreover, the large sample size included women who were primigravidae, under 40 years old, white-European ethnic background, and without epidural use during labour, in order to account for the significant confounding factors of parity, maternal age, ethnicity and labour analgesia on the success of induced labour 3 , 18 - 20 .…”

“…The inclusion criteria that were applied included primigravidae-only women with singleton cephalic presentation deliveries, who were under 40 years old, without the use of epidural analgesia during labour and who self-reported that they were of white-European ethnic background. We selected these inclusion criteria because there is evidence that parity, increased maternal age, use of an epidural and non-white-European ethnic background are all risk factors that have a confounding effect on the outcome of induced labour 3,[18][19][20] . Women who were induced for stillbirths, fetal congenital abnormalities and multiple pregnancies were excluded from the analysis.…”

“…Moreover, the large sample size included women who were primigravidae, under 40 years old, whiteEuropean ethnic background, and without epidural use during labour, in order to account for the significant confounding factors of parity, maternal age, ethnicity and labour analgesia on the success of induced labour 3,[18][19][20] .…”

“…The aim of our study was to investigate the effect of the maternal BMI at booking with the mode of delivery and the neonatal outcome in women with induced labour. In order to account for the significant confounding factors of parity 3 , maternal age 18 , use of an epidural in labour 19 and ethnicity 20 on the success of induced labour, we restricted the inclusion criteria of our women to those who were primigravidae, under 40 years, of white-European ethnic background, and who did not use an epidural for analgesia during labour. We compare our findings against the evidence from existing literature, and highlight the significant role of midwives in the weight management of women before and during pregnancy.…”

Observational study of induction of labour versus expectant management in overdate pregnancies amongst Indian women

“…The median gestational age at delivery for the Black and Asian population is around 39 weeks. 5 Hence, many obstetricians in our country prefer to induce the pregnant women as soon as they are over date (40 Available evidences comparing induction of labour with expectant management have demonstrated that Caesarean section rates are in fact reduced with induction of labour, however bulk of these studies have been conducted at 41 weeks of gestation. 6,7 In our teaching hospital, pregnancies that progress beyond their due date are managed either with induction of labour or expectant management.…”