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Table 4 Maternal complications according to policy of induced labor at term among large-for-gestational-age fetuses

From: Does induction of labor for constitutionally large-for-gestational-age fetuses identified in utero reduce maternal morbidity?

Women with a suspected large-for-gestational-age fetus

Induction of labor between 37 and 38 weeks+6 d(n = 199)%

Expectant management (n = 2878)%

Crude RR (95% CI)

Adjusted RR (95% CI)

Perineal lesions g

(n = 150)

(n = 1824)

 

1.06 (0.86-1.31)a

66.0

76.3

0.87 (0.77-0.97)

0.94 (0.84-1.05)b

  Episiotomies

43.8

55.5

0.79 (0.65-0.95)

0.93 (0.77-1.06)c

  Perineal tears

23.0

25.7

0.89 (0.64-1.25)

1.01 (0.72-1.40)d

   1 st and 2 nd degree h

20.6

24.2

-

-

  3 rd degree i

0.8

1.4

-

-

  4 th degree j

1.6

0.1

-

-

Cesarean section

(n = 199)

(n = 2872)

  

  Before labor

0

12.6

-

-

  During labor

21.6

18.6

1.16 (0.88-1.53)

1.11 (0.82-1.50)e

Severe maternal postpartum hemorrhage (>1 L)

(n = 168) 2.4

(n = 2308) 4.6

0.51 (0.19-1.38)

0.72 (0.27-1.93)f

  1. aRR adjusted for uterine scar, pregnancy-related disease other than large for-gestational-age status, operative vaginal delivery, and birth weight (<4000 g vs. ≥ 4000 g). Because of the interaction between induction and parity, the adjusted RR for induction is that for the primiparas.
  2. bRR adjusted for uterine scar, pregnancy-related disease other than large-for-gestational-age status, operative vaginal delivery, and birth weight (<4000 g vs. ≥ 4000 g). Because of the interaction between induction and parity, the adjusted RR for induction is that for the multiparas.
  3. cRR adjusted for parity (primiparas vs. multiparas), uterine scar, operative vaginal delivery, anesthesia (none vs. epidural analgesia or spinal anesthesia, vs. general anesthesia, vs. other anesthesia) and birth weight (<4000 g vs. ≥ 4000 g).
  4. dRR adjusted for parity (primiparas vs. multiparas), pregnancy-related disease other than large-for-gestational-age status, operative vaginal delivery, anesthesia (none vs. epidural analgesia or spinal anesthesia, vs. general anesthesia, vs. other anesthesia) and birth weight (<4000 g vs. ≥ 4000 g).
  5. eRR adjusted for parity (primiparas vs. multiparous), uterine scar, BMI (<20 vs 20–24 vs ≥ 25), pregnancy-related disease other than large-for-gestational-age status, anesthesia (general anesthesia vs. epidural analgesia or spinal anesthesia, vs. other anesthesia) and birth weight (<4000 g vs. ≥ 4000 g).
  6. fRR adjusted for parity, (primiparas vs. multiparas), uterine scar and birth weight (<4000 g vs. ≥ 4000 g).
  7. gDefined as any type of perineal tear and/or episiotomy.
  8. hFirst-degree tears involve damage to vaginal and perineal skin; second-degree tears involve the posterior vaginal wall and the underlying elevator and perineal muscles.
  9. iThird-degree tears involve the anal sphincter, with either total or partial damage to the sphincter and fourth-degree tears involve the anal sphincter and tears into the rectal mucosa.
  10. jFourth-degree tears involve the anal sphincter and tears into the rectal mucosa.
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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