Mode of delivery in nulliparous women with gestational hypertension undergoing early term induction of labor

Abstract

Objective: To evaluate perinatal outcomes in nulliparous women undergoing induction of labor for gestational hypertension at term.

Study design: Retrospective cohort study of nulliparous women with gestational hypertension undergoing induction of labor ≥37 weeks. Mode of delivery and perinatal outcomes were compared for women who delivered at 37^0-6/7, 38^0-6/7, and ≥39^0/7 weeks gestation.

Results: The cohort included 320 women: 67 (21%) at 37^0-6/7, 76 (24%) at 38^0-6/7, and 177 (55%) at ≥39^0/7. There was no increase in cesarean delivery (CD) in women delivering earlier, with 26.9% (37^0-6/7), 19.7% (38^0-6/7) and 29.9% (≥39^0/7) requiring CD (p values = 0.39). Compared to ≥39 weeks, composite maternal morbidity was lowest in women delivering at 38^0-6/7 (adjusted odds ratio [aOR] 0.45, 95% confidence interval (CI) 0.24-0.84). Composite neonatal morbidity was similar among the groups. When compared to women delivering at ≥39^0/7 weeks, women delivered at 38^0-6/7 were less likely to experience any adverse maternal or neonatal outcome (aOR 0.50, 95% CI 0.28-0.90).

Conclusions: Compared to induction of labor at ≥39 weeks, early term induction of labor was not associated with an increased risk of CD in nulliparous women with gestational hypertension.

Keywords: Gestational hypertension; cesarean delivery; induction of labor.