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J Matern Fetal Neonatal Med. 2010 May;23(5):383-8. doi: 10.3109/14767050903168432.

Is preeclampsia associated with an increased risk of cesarean delivery if labor is induced?

Author information

1
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California 94143-0132, USA. kimlh@obgyn.ucsf.edu

Abstract

OBJECTIVE:

To determine whether preeclampsia is associated with an increased risk of cesarean delivery if labor is induced.

METHODS:

This retrospective cohort study of 3505 women >or=24 weeks gestation with singleton pregnancies undergoing labor induction compares cesarean delivery rates between preeclamptics and non-preeclamptics. Multivariable logistic regression analysis was used to control for potential confounders including unfavorable cervix (Bishop score <or=5), method of labor induction, maternal age, parity, gestational age, race/ethnicity, epidural use, medical insurance, and marital status.

RESULTS:

Among term nulliparous women undergoing labor induction, preeclamptics had a higher cesarean delivery rate then non-preeclamptics (81/267, 30% vs. 363/1568, 23%; p = 0.011), as did preeclamptic compared with non-preeclamptic women who were term and multiparous (10/64, 16% vs. 55/900, 6%, p = 0.003). Preterm preeclamptics also had more cesarean deliveries compared with non-preeclamptics among nulliparous (48/164, 29% vs. 16/245, 7%; p < 0.001) and multiparous (13/72, 18% vs. 18/225, 8%; p = 0.015) women. In multivariable analysis, preeclampsia still conferred an increased risk of cesarean delivery if labor was induced (adjusted odd ratio = 1.90, 95% CI 1.45-2.48).

CONCLUSION:

Women with preeclampsia undergoing labor induction had higher cesarean delivery rates compared with non-preeclamptics regardless of parity or gestational age. However, the majority of women with preeclampsia still had successful vaginal deliveries.

PMID:
19951010
DOI:
10.3109/14767050903168432
[Indexed for MEDLINE]

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