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Labor

Poster Session 2

(543) Factors associated with successful elective induction of labor

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To determine factors associated with vaginal delivery (VD) among patients undergoing elective labor induction (eIOL).

Study Design: Retrospective cohort study of pregnancies undergoing eIOL from 2011-2022 at Kaiser Permanente Northern California. eIOL was defined as inductions between 39w0d-40w6d with no identifiable medical indications present per criteria derived from ACOG and the ARRIVE trial including maternal age < 15 or ≥40 years, gestational age >39 or ≥41 weeks, multiple gestation, rupture of membranes prior to hospital admission, maternal medical comorbidities, obstetric pathologies, or fetal pathologies. We evaluated the association of patient characteristics with vaginal delivery using multivariable regression analysis.

Results: Among the 274,039 39w0d-40w6d deliveries occurring during this time, 53,668 (19.6%) were IOL and of those, 10,709 (20%) were eIOL. Characteristics associated with vaginal delivery were induction in the 39th compared to induction in the 40th week (aOR 1.15; 95% CI 1.02-1.30), multiparity (aOR 8.07; 95% CI 6.96-9.36), and height (Table). Increasing age and BMI (Table), and Black (aOR 0.58; 95% CI 0.45-0.73) or Asian (0.68 95% CI 0.58-0.80) race categories were associated with decreased likelihood of vaginal delivery, after adjustment for maternal characteristics, induction method and prior cesarean

Conclusion:

Conclusion: Among those undergoing eIOL, factors associated with vaginal delivery included induction earlier in the term period, multiparity, white race, and use of oxytocin alone. Among otherwise healthy term pregnancies eligible for elective labor induction, opportunities to better understand racial inequities in vaginal delivery rates should be investigated.