Induction of labour as compared with spontaneous labour in low-risk women: A multicenter study in Catalonia

Objective: To compare birth and neonatal outcomes in low-risk women undergoing induced labour with those undergoing spontaneous onset. Methods: This retrospective multicentre study included 30 public maternity hospitals in Catalonia between 2016 and 2017. The study population consisted of 5,717 women. Results: Of the 5,717 births, 75.8% had spontaneous onset and 24.2% had an induction. Induced labour was more likely at week 41 of gestation and in nulliparous women. Induced labour increased the likelihood of undergoing caesarean section (adjusted OR [ORa], 2.59; 95% confidence interval [CI], 2.11-3.16), assisted vaginal birth (ORa, 1.70; 95% CI, 1.46-1.98), epidural analgesia (ORa, 2.64; CI, 2.14-3.27), postpartum haemorrhage (ORa, 1.56; 95% CI, 1.14-2.15) and episiotomy (ORa, 1.26; 95% CI, 1.08-1.47). Induced labour was also associated with not performing skin-to-skin contact with the mother (ORa, 0.47; 95% CI, 0.39-0.58) and with not performing early breastfeeding (ORa, 0.49; 95% CI, 0.39-0.61). Conclusions: The frequency of labour inductions among low-risk women exceeds the level recommended by scientific organisations in Catalonia and Spain, and is associated with adverse birth outcomes such as increased caesarean section rates, assisted vaginal births, and episiotomy rates. It is also associated with the failure to perform early skin-to-skin contact with the mother and failure to initiate early breastfeeding.