Peripartum interventions and outcomes for women and children in uncomplicated pregnancies: a 16-year population-based linked data study. 

Dahlen HG, Thornton C, Downe S, et al. Intrapartum interventions and outcomes for women and children after delivery in uncomplicated pregnancies: a 16-year population-based linked data study BMJ Open 2021; 11: e047040. doi: 10.1136/bmjopen-2020- 047040

Commentary

This study of induction of labor (IOL) and spontaneous onset of labor in uncomplicated full-term pregnancies with childbirth was designed to compare interventions and outcomes at delivery for mothers, newborns, and children up to 16 years of age.

We used population-related data from New South Wales, Australia (2001-2016) for healthy women giving birth at 37+ 0 to 41 + 6 weeks.

Of the 474,652 births, 69,397 (15%) had IOL for non-medical reasons, and first-time mothers with IOL and spontaneous onset were significantly more likely to have spontaneous (42.7% vs. 62.3%), instrumental (28.0% vs. 23.9 %), partial cesarean (29.3% vs. 13.8%), and epidural (71.0% vs. (41.3 %), epidural (71.0 % vs.

In both groups, third- and fourth-degree perineal tears were lower overall in the IOL group, women with first births (4.2% vs. 4.9%) and women with preterm births (0.7% vs. 1.2%), but overall vaginal repair was higher. (89.3 percent vs. 84.3 percent)

After its introduction, there was a higher incidence of birth trauma, resuscitation and respiratory problems in newborns, as well as hospitalization for infections (ear, nose, throat, respiratory and sepsis) up to 16 years. There was no difference in hospitalizations for asthma or eczema, neonatal deaths (0.06% vs. 0.08%), or total deaths up to 16 years.