Induction versus expectant management at 41 weeks


  • Mary Corcoran
  • Univadis Medical News
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Inducing labour at 41 weeks in low-risk pregnancies is associated with a lower risk of newborn mortality compared with expectant management until 42 weeks, suggests a new trial published in the BMJ.

The trial included 2,760 women with an uncomplicated, singleton pregnancy recruited from 14 Swedish hospitals between 2016 and 2018. Women were randomly assigned to induction at 41 weeks (n=1,381) or expectant management (n=1,379) until induction at 42 weeks if necessary.

The primary outcome was a composite perinatal outcome including stillbirth or neonatal mortality, Apgar score

The researchers found no difference between the groups for the composite primary outcome. However, the trial was stopped early due to a significantly higher rate of perinatal mortality in the expectant management group. Six infants died in this group compared with none in the induction group. The authors estimated the number needed to treat with induction of labour at 41 weeks to prevent one perinatal death was 230. 

“Although these results should be interpreted cautiously, induction of labour ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths,” the authors concluded.