ArticleBirth (Berkeley, Calif.)2017
Labor induction and cesarean delivery: A prospective cohort study of first births in Pennsylvania, USA.
Article in Birth (Berkeley, Calif.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Prevalence of Labor Induction, its Indication, and Feto-Maternal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis.Inquiry : a journal of medical care organization, provision and financingPooled it
- Predicting failed trial of labor in advanced-age primiparas: development and validation of a clinical nomogram.BMC pregnancy and childbirth · 2026Article
- Establishment and Validation of a Risk Prediction Model for Cephalic Dystocia in Parturients Under Epidural Labor Analgesia.International journal of women's health · 2026Article
- Influence of premature rupture of membranes on the peripartum outcomes in vaginally intended breech deliveries at term: A FRABAT study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Labor Induction versus Expectant Management: Evaluating Maternal and Neonatal Outcomes in Low-Risk Nulliparous Women.Journal of pharmacy & bioallied sciences · 2025Article
- Mode of Delivery in Greece: A Study of Obstetricians' Personal Preferences Regarding Delivery of Their Offspring.Journal of clinical medicine · 2025Article
- Fetomaternal Outcomes of Severe Anemia in Pregnancy: A Prospective Observational Study.Cureus · 2024Article
- Vaginal delivery following induction and associated factors among laboring women at South Wollo Zone Public Hospitals of Ethiopia, 2023.Scientific reports · 2024Article
- The association between prenatal psychosocial factors and autism spectrum disorder in offspring at 3 years: a prospective cohort study.Social psychiatry and psychiatric epidemiology · 2024Article
- How Much is too Much? High Utilization of Prenatal Care and Its Impact on Primary Cesarean Birth Among Women in the United States.Maternal and child health journal · 2024Article
- Induction of labour practices at Botshabelo District Hospital: Assessing the institutional guidelines.Journal of public health in Africa · 2022Article
- The Role of Oxytocin in Primary Cesarean Birth Among Low-Risk Women.Journal of midwifery & women's health · 2021Article
- Proportion and Outcome of Induction of Labor Among Mothers Who Delivered in Teaching Hospital, Southwest Ethiopia.Frontiers in public health · 2021Article
- Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: A Consortium on Safe Labor study.Birth (Berkeley, Calif.) · 2019Observational
- Factors influencing women's perceptions of shared decision making during labor and delivery: Results from a large-scale cohort study of first childbirth.Patient education and counseling · 2018Article
- A flexible wearable system for uterine contraction monitoring and admission decision support.Digital healthArticle
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundMode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery.
methodsA prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction, and the mediating (intrapartum) factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor, dystocia, fetal intolerance of labor, and maternal request of cesarean during labor.
resultsMore than a third of the women were induced (34.3%) and 24.8% underwent cesarean delivery. Induced women were more likely to deliver by cesarean (35.9%) than women in spontaneous labor (18.9%), unadjusted OR 2.35 (95% CI 1.97-2.79). The intrapartum factors significantly mediated the association between labor induction and cesarean delivery (explaining 76.7% of this association), particularly cervical dilatation <3 cm at hospital admission, fetal intolerance of labor, and dystocia. The indications for labor induction only explained 6.2%.
conclusionsIncreased risk of cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications.
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