Evidence around early induction of labor in women of advanced maternal age and those using assisted reproductive technology

Venkatanarayanan, Nandini; Walker, Kate F.

Abstract

Worldwide, there has been a trend toward later motherhood. Concurrently, the incidence of subfertility has been on the rise, necessitating conception using assisted reproductive technologies (ARTs). These pregnancies are considered high risk due to fetal complications such as antepartum stillbirth and growth restriction and maternal complications such as increase in maternal morbidity and mortality. Early induction of labor can help to mitigate these risks. However, this has to be balanced against the iatrogenic harms of earlier delivery to both the baby, including respiratory distress and NICU stay, and the mother who might experience longer labor and other complications such as uterine hyperstimulation. Induction of labor at 39 weeks is the optimal timing for preventing antepartum stillbirth and avoiding iatrogenic harm. Delivery by elective cesarean section is not advocated as its benefits in these patients are unclear compared with the short- and long-term complications of a major abdominal surgery.

Citation

Venkatanarayanan, N., & Walker, K. F. (2021). Evidence around early induction of labor in women of advanced maternal age and those using assisted reproductive technology. Best Practice and Research: Clinical Obstetrics and Gynaecology, 77, 42-52. https://doi.org/10.1016/j.bpobgyn.2021.08.007

• Journal Article Type: Article
• Acceptance Date: Aug 19, 2021
• Online Publication Date: Sep 15, 2021
• Publication Date: Nov 1, 2021
• Deposit Date: Dec 22, 2021
• Publicly Available Date: Sep 16, 2022
• Journal: Best Practice and Research: Clinical Obstetrics and Gynaecology
• Print ISSN: 1521-6934
• Electronic ISSN: 1532-1932
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Pages: 42-52
• DOI: https://doi.org/10.1016/j.bpobgyn.2021.08.007
• Keywords: Obstetrics and Gynecology; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/7056419
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1521693421001218?via%3Dihub