SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2014
Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.
Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03025581 (Does Nipple Stimulation Shorten Time to Vaginal Birth in Women With Term PROM?), which is not on this map. Cited by 58 papers, 9 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.
Does Nipple Stimulation Shorten Time to Vaginal Birth in Women With Term PROM? (NIPROM Study)
Who cites it
58 citing papers in PubMed, 9 syntheses or guidelines pooled it, 324 citations in OpenAlex.
- Induction of labour at or near term for suspected fetal macrosomia.The Cochrane database of systematic reviews · 2023Pooled it
- Induction of labour at or beyond 37 weeks' gestation.The Cochrane database of systematic reviews · 2020Pooled 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
- Delivery or expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disorders of pregnancy: an individual participant data meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2019Pooled it
- Induction of labour for improving birth outcomes for women at or beyond term.The Cochrane database of systematic reviews · 2018Pooled it
- Pooled it
- Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis.BMJ open · 2017Pooled it
- Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more).The Cochrane database of systematic reviews · 2017Pooled it
- Induction of labour at or near term for suspected fetal macrosomia.The Cochrane database of systematic reviews · 2016Pooled it
- Timing of birth to improve outcomes in chronic or gestational hypertension: the WILL RCT.Health technology assessment (Winchester, England) · 2026Trial
- Women's Childbirth Experiences in the WILL Randomised Trial (When to Induce Labour to Limit Risk in Pregnancy Hypertension): A Mixed Methods Analysis.BJOG : an international journal of obstetrics and gynaecology · 2025Trial
- Trial
- Labor induction at 41Acta obstetricia et gynecologica Scandinavica · 2024Trial
- Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy.International journal of women's health · 2022Trial
- 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
- A randomized controlled trial of differing doses of postcesarean enoxaparin thromboprophylaxis in obese women.Journal of perinatology : official journal of the California Perinatal Association · 2016Trial
- Assessing the impact of indication for labor induction on delivery outcomes: a five-year cohort study.BMC pregnancy and childbirth · 2026Article
- Use of artificial intelligence to study the hospitalization of women undergoing caesarean section.BMC public health · 2025Article
- Hypertensive Disorders of Pregnancy: Diagnosis, Management and Timing of Birth.Balkan medical journal · 2024Review
- The preimplantation genetic testing for monogenic disorders strategy for blocking the transmission of hereditary cancers through haplotype linkage analysis by karyomapping.Journal of assisted reproduction and genetics · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInduction of labour is common, and cesarean delivery is regarded as its major complication. We conducted a systematic review and meta-analysis to investigate whether the risk of cesarean delivery is higher or lower following labour induction compared with expectant management.
methodsWe searched 6 electronic databases for relevant articles published through April 2012 to identify randomized controlled trials (RCTs) in which labour induction was compared with placebo or expectant management among women with a viable singleton pregnancy. We assessed risk of bias and obtained data on rates of cesarean delivery. We used regression analysis techniques to explore the effect of patient characteristics, induction methods and study quality on risk of cesarean delivery.
resultsWe identified 157 eligible RCTs (n = 31,085). Overall, the risk of cesarean delivery was 12% lower with labour induction than with expectant management (pooled relative risk [RR] 0.88, 95% confidence interval [CI] 0.84-0.93; I(2) = 0%). The effect was significant in term and post-term gestations but not in preterm gestations. Meta-regression analysis showed that initial cervical score, indication for induction and method of induction did not alter the main result. There was a reduced risk of fetal death (RR 0.50, 95% CI 0.25-0.99; I(2) = 0%) and admission to a neonatal intensive care unit (RR 0.86, 95% CI 0.79-0.94), and no impact on maternal death (RR 1.00, 95% CI 0.10-9.57; I(2) = 0%) with labour induction.
interpretationThe risk of cesarean delivery was lower among women whose labour was induced than among those managed expectantly in term and post-term gestations. There were benefits for the fetus and no increased risk of maternal death.
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.