A Cochrane review [Abstract] 1 included 34 trials with over 21 000 women. A policy of labour induction at 41 completed weeks or beyond was associated with fewer (all-cause) perinatal deaths (table T1). The number needed to treat to benefit (NNTB) with induction of labour in order to prevent one perinatal death was 544 (95% CI 441 to 1042). There were slightly fewer caesarean sections, but little or no difference in operative vaginal births in the induction group compared with expectant management.
| Outcome | Relative effect(95% CI) RR | Risk with expectant management | Risk with labour induction (95% CI) | №of participants(studies)Quality of evidence |
|---|---|---|---|---|
| Perinatal death | 0.31(0.15 to 0.64) | 3 per 1000 | 0.4 per 1000(0.1 to 1.9) | 18 795(22) High |
| Stillbirth | 0.30(0.12 to 0.75) | 2 per 1000 | 1 per 1000(0.15 to 1.5) | 18 795(22) High |
| Admission to neonatal intensive care unit | 0.88(0.80 to 0.96) | 95 per 1000 | 83 per 1000(80 to 91) | 17 826(17) High |
| Apgar score less than 7 at 5 minutes | 0.73(0.56 to 0.96) | 13 per 1000 | 10 per 1000(7 to 12) | 18 345(20) Moderate |
| Caesarean section | 0.90(0.85 to 0.95) | 186 per 1000 | 167 per 1000(158 to 177) | 21 030(31) Moderate |
| Operative vaginal birth (forceps or ventouse) | 1.03(0.96 to 1.10) | 136 per 1000 | 140 per 1000(131 to 150) | 18 584(22) Moderate |
Primary/Secondary Keywords