Objective. To determine whether preeclampsia is associated with an increased risk of cesarean delivery if labor is induced. Methods. This retrospective cohort study of 3505 women ≥24 weeks gestation with singleton pregnancies undergoing labor induction compares cesarean delivery rates between preeclamptics and non-preeclamptics. Multivariable logistic regression analysis was used to control for potential confounders including unfavorable cervix (Bishop score ≤5), method of labor induction, maternal age, parity, gestational age, race/ethnicity, epidural use, medical insurance, and marital status. Results. Among term nulliparous women undergoing labor induction, preeclamptics had a higher cesarean delivery rate then non-preeclamptics (81/267, 30% vs.363/1568, 23%; p=0.011), as did preeclamptic compared with non-preeclamptic women who were term and multiparous (10/64, 16% vs.55/900, 6%, p=0.003). Preterm preeclamptics also had more cesarean deliveries compared with non-preeclamptics among nulliparous (48/164, 29% vs.16/245, 7%; p<0.001) and multiparous (13/72, 18% vs.18/225, 8%; p=0.015) women. In multivariable analysis, preeclampsia still conferred an increased risk of cesarean delivery if labor was induced (adjusted odd ratio=1.90, 95% CI 1.45-2.48). Conclusion. Women with preeclampsia undergoing labor induction had higher cesarean delivery rates compared with non-preeclamptics regardless of parity or gestational age. However, the majority of women with preeclampsia still had successful vaginal deliveries.
- Cesarean delivery
- Labor induction
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology