Trial reportAmerican journal of obstetrics and gynecology2020
Health resource utilization of labor induction versus expectant management.
Trial report in American journal of obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Induction of labour at or beyond 37 weeks' gestation.The Cochrane database of systematic reviews · 2020Pooled it
- Cost of Elective Labor Induction Compared With Expectant Management in Nulliparous Women.Obstetrics and gynecology · 2020Trial
- Comparing Costs to the Public Healthcare System Between Induction of Labor and Expectant Management, Stratified by Parity and Gestation: An Australian Population-Based, Retrospective Cohort Study.Birth (Berkeley, Calif.) · 2026Article
- Clinical examination for identifying low-risk pregnancies suitable for expectant management beyond 40-41 gestational weeks: maternal and fetal outcomes.Archives of gynecology and obstetrics · 2025Article
- Risk factors for postpartum readmission: a prediction model in Iranian pregnant women.BMC pregnancy and childbirth · 2024Article
- Article
- Is the increasing prevalence of labor induction accompanied by changes in pregnancy outcomes? An observational study of all singleton births at gestational weeks 37-42 in Norway during 1999-2019.Acta obstetricia et gynecologica Scandinavica · 2023Observational
- Using the WHO-INTEGRATE evidence-to-decision framework to develop recommendations for induction of labour.Health research policy and systems · 2022Article
- Head in the sand: Contemporary Australian attitudes towards induction of labour.The Australian & New Zealand journal of obstetrics & gynaecology · 2022Article
- Labor Induction at 39 Weeks Compared with Expectant Management in Low-Risk Parous Women.American journal of perinatology · 2022Observational
- American College of Nurse-Midwives Clinical Bulletin Number 18: Induction of Labor.Journal of midwifery & women's health · 2022Review
- Article
- Out-of-Hospital Cervical Ripening With a Synthetic Hygroscopic Cervical Dilator May Reduce Hospital Costs and Cesarean Sections in the United States-A Cost-Consequence Analysis.Frontiers in public healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 19 institutions in 2 countries.
Funding
Abstract
backgroundAlthough induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization.
objectiveThe objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY
designThis is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management. We assessed resource utilization after randomization in 3 time periods: antepartum, delivery admission, and discharge through 8 weeks postpartum.
resultsOf 6096 women with data available, those in the induction of labor group (n = 3059) were significantly less likely in the antepartum period after randomization to have at least 1 ambulatory visit for routine prenatal care (32.4% vs 68.4%), unanticipated care (0.5% vs 2.6%), or urgent care (16.2% vs 44.3%), or at least 1 antepartum hospitalization (0.8% vs 2.2%, P < .001 for all). They also had fewer tests (eg, sonograms, blood tests) and treatments (eg, antibiotics, intravenous hydration) prior to delivery. During the delivery admission, women in the induction of labor group spent a longer time in labor and delivery (median, 0.83 vs 0.57 days), but both women (P = .002) and their neonates (P < .001) had shorter postpartum stays. Women and neonates in both groups had similar frequencies of postpartum urgent care and hospital readmissions (P > .05 for all).
conclusionWomen randomized to induction of labor had longer durations in labor and delivery but significantly fewer antepartum visits, tests, and treatments and shorter maternal and neonatal hospital durations after delivery. These results demonstrate that the health outcome advantages associated with induction of labor are gained without incurring uniformly greater health care resource use.
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