Is preeclampsia associated with an increased risk of cesarean delivery if labor is induced?

Lena Heesun Kim, Yvonne W. Cheng, Shani Delaney, Angie Child Jelin, Aaron B. Caughey

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)383-388
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume23
Issue number5
DOIs
StatePublished - May 1 2010
Externally publishedYes

Keywords

  • Cesarean delivery
  • Labor induction
  • Preeclampsia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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