Evidence map›Paper›PMID 40133890›Full record

Observational studyBMC pregnancy and childbirth2025

Does induction of labor without a medical indication explain the overall increase in the induction rate: an observational study before and after the ARRIVE trial.

Isabelle Attali, Julie Cormier, François Goffinet, Camille Le Ray

Abstract readObservational Study
In one paragraph

Observational study in BMC pregnancy and childbirth, 2025. 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
–field-weighted citation impact
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.

  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

4 authors.

Isabelle AttaliPort Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, Paris, 75014, France. attali.isabelle@gmail.com.
Julie CormierPort Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, Paris, 75014, France.
François GoffinetPort Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, Paris, 75014, France.
Camille Le RayPort Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, Paris, 75014, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rate of induction of labor increased particularly after the publication of ARRIVE trial conducted in low-risk primiparous patients without medical indication. However, this increase of induction rate does not seem to concern this population alone. Our aim was to understand how induction rate have evolved according to its indications and the impact on cesarean rate.

methodsThis was a retrospective observational study in a tertiary university maternity unit, including all women who gave birth between January 1st 2014 and December 31th 2021, at more than 24 weeks of gestation with a liveborn infant weighing ≥ 500 g (N = 9,523). We described the frequency of induction and caesarean section per year within the maternity unit. We differentiated two study periods: 2014-2017 and 2018-2021. We used the Grenoble classification to analyse the contribution of each of group to the overall induction rate and calculated the absolute and relative difference in induction rate for each group between the two periods. We analysed changes in the risk of caesarean section in each of the groups.

resultsThe overall induction rate increased from 19.3 to 27.4% between 2014 and 2021 (p < 0.01). The cesarean section rate for women who underwent induction decreased significantly from 29.5% in 2014 to 25.2% in 2021 (p < 0.01). The induction rate moderately increased in the group corresponding to induction of labor "without medical indication" (relative difference of 14.9%; 95%CI [6.0;21.0]). The groups with the greatest increase in their induction rate between the two study periods were the breech group (relative difference of 66.7% 95%CI [49.0;83.0]) and the fetal pathology induction group (relative difference of 75.5% 95%CI [61.2;90.1]). The rate of cesarean among inducted women reduced significantly in the group of "multiple pregnancies" (aOR = 0.6; 95%CI [0.4;0.9]) and in the group of "maternal pathologies" (aOR = 0.8; 95%CI [0.6;0.9]). For the group 8 "induction without medical induction" the reduction was not significant (aOR = 0.8; 95%CI [0.8;1.2]).

conclusionFrom 2014 to 2021, we observed a marked increase in the induction rate in our maternity unit. This increase was not associated with a change of the cesarean rate. Induction of labor without medical indication represent only a small part of the induction rate.

Indexed as

Cesarean SectionLabor, InducedAdultFemaleHumansPregnancyRetrospective StudiesCaesarean section rateDeliveryEpidemiologyInduction of labor

Identifiers

PMID40133890
PMCPMC11934459

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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.