New research suggests inducing labor in late-term pregnancies may be a safer choice than taking a “wait and see” approach, indicating induced labor at 41 weeks may reduce the risk of infant stillbirths.
In findings published last week in the medical journal The BMJ, Swedish researchers concluded more infants were stillborn when doctors waited to see what would happen in later term pregnancies, instead of inducing labor by 41 weeks if the mother was past her due date.
Researchers studied more than 2,700 women in 14 hospitals in Sweden from 2016 to 2018, consisting of pregnant women with a low risk, uncomplicated pregnancies. Half of the group was assigned to be induced at 41 weeks pregnancy. The other half were assigned to the expectant management group, or the “wait and see” approach, and induced at 42 weeks if necessary.
A normal pregnancy term is 40 weeks. Infants born late, at or beyond 42 weeks, often have increased risk of suffering health problems, such as pneumonia, breathing problems, and sepsis. Some studies in the past have indicated inducing labor at 41 weeks reduces the likelihood of those risks.
The 41 week induction group had a complication rate of 2.46% compared to 2.2% in the wait and see group. The rate of c-section delivery, instrumental vaginal delivery, or any major maternal death was not different between the groups. However, the wait and see group had six stillbirth deaths and one early neonatal death. By comparison, there were no deaths in the 41 week induction group.
A stillbirth occurs when the infant dies in the womb after having survived at least 28 weeks of pregnancy. It can also occur late in the pregnancy due to problems with the placenta or fetal development issues. Often, there is no known cause or reason. About 1 in 100 infants or 24,000 babies are stillborn in the U.S. every year.
The new study was stopped early due to a significantly higher rate of infant stillbirth death in the “wait and see” management group compared to inducing at 41 weeks.
Researcher determined that women with late term pregnancies which pose a low risk should be informed of the risks of waiting, compared to inducing at 41 weeks. They should be offered induction no later than 41 weeks, the researchers concluded.
“Although these results should be interpreted cautiously, induction of labour ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths,” the study authors wrote.