ArticleBMJ (Clinical research ed.)2012
Outcomes of elective induction of labour compared with expectant management: population based study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Comparison of Maternal Labor-Related Complications and Neonatal Outcomes Following Elective Induction of Labor at 39 Weeks of Gestation vs Expectant Management: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2021Pooled it
- Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies.PLoS medicine · 2019Pooled it
- Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants.The Cochrane database of systematic reviews · 2019Pooled it
- Effects of induction of labor prior to post-term in low-risk pregnancies: a systematic review.JBI database of systematic reviews and implementation reports · 2019Pooled it
- Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Pooled it
- Evaluation of the Growth Assessment Protocol (GAP) for antenatal detection of small for gestational age: The DESiGN cluster randomised trial.PLoS medicine · 2022Trial
- Customized Probability of Vaginal Delivery With Induction of Labor and Expectant Management in Nulliparous Women at 39 Weeks of Gestation.Obstetrics and gynecology · 2020Trial
- Elective Labor Induction at 39 Weeks of Gestation Compared With Expectant Management: Factors Associated With Adverse Outcomes in Low-Risk Nulliparous Women.Obstetrics and gynecology · 2020Trial
- Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.The New England journal of medicine · 2018Trial
- Study protocol of SWEPIS a Swedish multicentre register based randomised controlled trial to compare induction of labour at 41 completed gestational weeks versus expectant management and induction at 42 completed gestational weeks.BMC pregnancy and childbirth · 2016Trial
- Optimal Timing of Term Births by Maternal Region of Birth: Elective Induction of Labor Compared to Expectant Management in Victoria, Australia.Birth (Berkeley, Calif.) · 2026Article
- Neonatal Outcomes Following Elective Induction of Labor at 39 Weeks: A Systematic Review.Cureus · 2025Review
- Labor Induction versus Expectant Management: Evaluating Maternal and Neonatal Outcomes in Low-Risk Nulliparous Women.Journal of pharmacy & bioallied sciences · 2025Article
- Optimal timing for induction of labor in normotensive women: A retrospective cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- The rising tide: Trends in induction of labor at term over a 5-year period at a single centre.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Observational
- Perinatal mortality and other severe adverse outcomes following planned birth at 39 weeks versus expectant management in low-risk women: a population based cohort study.EClinicalMedicine · 2025Article
- Maternal and perinatal outcomes after implementation of a more active management in late- and postterm pregnancies in Sweden: A population-based cohort study.PLoS medicine · 2025Article
- Cervical ripening at home or in hospital during induction of labour: the CHOICE prospective cohort study, process evaluation and economic analysis.Health technology assessment (Winchester, England) · 2024Observational
- Caesarean Section frequency in Nulliparous Women induced at 39 weeks versus conventional management: An open label random allocation study.Pakistan journal of medical sciences · 2024Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
Authors and funding
6 authors.
Funding
Abstract
objectiveTo determine neonatal outcomes (perinatal mortality and special care unit admission) and maternal outcomes (mode of delivery, delivery complications) of elective induction of labour compared with expectant management.
designRetrospective cohort study using an unselected population database.
settingConsultant and midwife led obstetric units in Scotland 1981-2007.
participants1,271,549 women with singleton pregnancies of 37 weeks or more gestation.
interventionsOutcomes of elective induction of labour (induction of labour with no recognised medical indication) at 37, 38, 39, 40, and 41 weeks' gestation compared with those of expectant management (continuation of pregnancy to either spontaneous labour, induction of labour or caesarean section at a later gestation).
main outcome measuresExtended perinatal mortality, mode of delivery, postpartum haemorrhage, obstetric anal sphincter injury, and admission to a neonatal or special care baby unit. Outcomes were adjusted for age at delivery, parity, year of birth, birth weight, deprivation category, and, where appropriate, mode of delivery.
resultsAt each gestation between 37 and 41 completed weeks, elective induction of labour was associated with a decreased odds of perinatal mortality compared with expectant management (at 40 weeks' gestation 0.08% (37/44,764) in the induction of labour group versus 0.18% (627/350,643) in the expectant management group; adjusted odds ratio 0.39, 99% confidence interval 0.24 to 0.63), without a reduction in the odds of spontaneous vertex delivery (at 40 weeks' gestation 79.9% (35,775/44,778) in the induction of labour group versus 73.7% (258,665/350,791) in the expectant management group; adjusted odds ratio 1.26, 1.22 to 1.31). Admission to a neonatal unit was, however, increased in association with elective induction of labour at all gestations before 41 weeks (at 40 weeks' gestation 8.0% (3605/44,778) in the induction of labour group compared with 7.3% (25,572/350,791) in the expectant management group; adjusted odds ratio 1.14, 1.09 to 1.20).
conclusionAlthough residual confounding may remain, our findings indicate that elective induction of labour at term gestation can reduce perinatal mortality in developed countries without increasing the risk of operative delivery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.