A new study published today in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG) suggests that a proactive labour induction practice in Denmark has improved perinatal outcomes.
The study assessed the changes in perinatal outcomes in children born from 37 weeks gestation after implementation of a proactive labour induction practice from 2009. Currently the national Danish guidelines recommend labour induction at week 41 and 3 – 5 days, and even earlier in high-risk pregnant women, with a goal to ensure delivery by 42 weeks.
The results found that the risk of neonatal death was almost halved from 1.9 to 1.0 per 1,000 births from 2000 to 2012. The risk of asphyxia decreased by 23% from 2003 to 2012, which also led to a decrease in the incidence rate of cerebral palsy by 26% from 2002 to 2010.
Throughout the study period, the risk of birth weight of more than 4500g, defined as macrosomia, decreased by one-third and peripheral nerve injury decreased by 43%.
In the UK, current guidelines from the National Institute for Health and Care Excellence (NICE) recommend that women with uncomplicated pregnancies should usually be offered induction of labour between 41 and 42 weeks to avoid the risks of prolonged pregnancy. The exact timing should take into account the woman's preferences and local circumstances.
According to NHS Maternity Statistics, 25% of deliveries between 2013 and 2014 were surgically and/or medically induced in England.
Commenting on the study, Professor Alan Cameron, RCOG Vice President for Clinical Quality said:
“This is a very interesting study which highlights that proactive labour induction in Denmark has seen improved perinatal outcomes, including the reduced risk of neonatal death, large babies, asphyxia and cerebral palsy.
"Currently NICE guidelines recommend that a woman should be induced between 41 and 42 weeks of gestation, similar to the practice in Denmark. This guideline is based on the latest scientific evidence and offers the best practice advice on how to care for pregnant women and their babies.
“Induction is very common, is offered for good medical reasons and is safe. However, it can be less efficient and more painful than spontaneous labour. Induction can also place more strain on labour wards than spontaneous labour and these factors must also be considered.
“Treatment and care should always take into account women's individual needs and preferences. Women should have the opportunity to make informed decisions in partnership with their healthcare professionals.”
For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email email@example.com.
Read the NICE guidance Induction of labour.
Read the RCOG Scientific Impact Paper Induction of Labour at Term in Older Mothers.
NHS Maternity Statistics are available to view here.
M Hedegaard, Ø Lidegaard, C W Skovlund, L S Mørch, M Hedegaard. Perinatal outcomes following an earlier post-term labour induction policy: a historical cohort study. BJOG 2015; http://dx.doi.org/10.1111/1471-0528.13299