Complications of labor induction among multiparous women in a community-based hospital system

OBJECTIVE: The purpose of this study was to examine complications of labor induction compared to spontaneous labor in multiparas. STUDY DESIGN: This was a retrospective cohort study of multiparous women with live, singleton pregnancies at term, who had no contraindications to labor or labor induction. Cesarean delivery was the primary outcome. RESULTS: Of the study subjects, 7208 experienced spontaneous labor, 2190 underwent labor induction with oxytocin, and 239 underwent labor induction requiring cervical ripening agents. Oxytocin-induced multiparas were 37% more likely to require cesarean compared to those with spontaneous labor (OR, 1.37; 95% CI, 1.10- 1.71) and nearly 3 times more likely to undergo cesarean when cervical ripening agents were used (OR, 2.82; 95% CI, 1.84-4.53). Women requiring cervical ripening were also 10 times more likely to spend more than 12 hours in labor than those with spontaneous labor. CONCLUSION: Multiparas undergoing labor induction are at increased risk for obstetric complications compared to spontaneous labor.