Evidence map›Paper›PMID 31783795›Full record

ArticleBMC pregnancy and childbirth2019

The risk of cesarean delivery after labor induction among women with prior pregnancy complications: a subgroup analysis of the AFFIRM study.

Leslie Skeith, Grégoire Le Gal, Johanna I P de Vries, Saskia Middeldorp, Mariëtte Goddijn, Risto Kaaja, Jean-Christophe Gris, Ida Martinelli, Ekkehard Schleußner, David Petroff and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 22% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 6 countries.

Leslie SkeithDivision of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, C210 Foothills Medical Centre, 1403 29th Street, NW, Calgary, Alberta, T2N 2T9, Canada. laskeith@ucalgary.ca.ORCID http://orcid.org/0000-0002-5587-398X
Grégoire Le GalClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Johanna I P de VriesDepartment of Obstetrics and Gynecology, VU Medical Center, Amsterdam, the Netherlands.
Saskia MiddeldorpAcademic Medical Center, Department of Vascular Medicine, Amsterdam, the Netherlands.
Mariëtte GoddijnAcademic Medical Center, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Amsterdam, the Netherlands.
Risto KaajaDepartment of Medicine, University of Turku and Turku University Hospital, Turku, Finland.
Jean-Christophe GrisDepartment of Hematology, Nimes University Hospital and University of Montpellier, Montpellier, France.
Ida MartinelliA. Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
Ekkehard SchleußnerDepartment of Obstetrics and Gynecology, Jena University Hospital Friedrich Schiller University, Jena, Germany.
David PetroffClinical Trial Centre, University of Leipzig, Leipzig, Germany.
Nicole LangloisClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Marc A RodgerClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
AFFIRM investigators
Amsterdam UMC Location University of Amsterdam · NLOttawa Hospital · CAUniversity of Calgary · CAUniversity of Ottawa · CAUniversity of Turku · FICentre Hospitalier Universitaire de Montpellier · FRFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITFriedrich Schiller University Jena · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction).

methodsThe AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor.

resultsThere were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p = 0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p = 0.01).

conclusionsThe risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.

Indexed as

Cesarean SectionLabor, InducedLabor, ObstetricAdultAnticoagulantsDatabases, FactualFemaleHeparin, Low-Molecular-WeightHumansPregnancyPregnancy ComplicationsRetrospective StudiesYoung AdultAnticoagulantsHeparin, Low-Molecular-WeightCesarean sectionInduced laborLow-molecular-weight heparinPre-eclampsia

Identifiers

PMID31783795
PMCPMC6884748
OpenAlexW2989856304

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.