Mode of delivery in nulliparous women with gestational hypertension undergoing early term induction of labor

Objective: To evaluate perinatal outcomes in nulliparous women undergoing induction of labor for gestational hypertension at term.Study design: Retrospective cohort study of nulliparous women with gestational hypertension undergoing induction of labor 37 weeks. Mode of delivery and perinatal outcomes were compared for women who delivered at 37(0-6/7), 38(0-6/7), and 39(0/7) weeks gestation.Results: The cohort included 320 women: 67 (21%) at 37(0-6/7), 76 (24%) at 38(0-6/7), and 177 (55%) at 39(0/7). There was no increase in cesarean delivery (CD) in women delivering earlier, with 26.9% (37(0-6/7)), 19.7% (38(0-6/7)) and 29.9% (39(0/7)) requiring CD (p values=0.39). Compared to 39 weeks, composite maternal morbidity was lowest in women delivering at 38(0-6/7) (adjusted odds ratio [aOR] 0.45, 95% confidence interval (CI) 0.24-0.84). Composite neonatal morbidity was similar among the groups. When compared to women delivering at 39(0/7) weeks, women delivered at 38(0-6/7) were less likely to experience any adverse maternal or neonatal outcome (aOR 0.50, 95% CI 0.28-0.90).Conclusions: Compared to induction of labor at 39 weeks, early term induction of labor was not associated with an increased risk of CD in nulliparous women with gestational hypertension.