A Cochrane review «Induction of labour at or beyond 37 weeks' gestation»1 «Middleton P, Shepherd E, Morris J et al. Induction of labour at or beyond 37 weeks' gestation. Cochrane Database Syst Rev 2020;(7):CD004945. »1 included 34 trials with over 21 000 women. A policy of labour induction at 41 completed weeks or beyond was associated with fewer (all-cause) perinatal deaths (table «Labour induction versus expectant management »1). The number needed to treat to benefit (NNTB) with induction of labour in order to prevent one perinatal death was 544 (95% CI 441 to 1042). There were slightly fewer caesarean sections, but little or no difference in operative vaginal births in the induction group compared with expectant management.
| Outcome | Relative effect (95% CI) RR | Risk with expectant management | Risk with labour induction (95% CI) | № of participants (studies) Quality of evidence |
|---|---|---|---|---|
| Perinatal death | 0.31 (0.15 to 0.64) | 3 per 1000 | 0.4 per 1000 (0.1 to 1.9) | 18 795 (22) High |
| Stillbirth | 0.30 (0.12 to 0.75) | 2 per 1000 | 1 per 1000 (0.15 to 1.5) | 18 795 (22) High |
| Admission to neonatal intensive care unit | 0.88 (0.80 to 0.96) | 95 per 1000 | 83 per 1000 (80 to 91) | 17 826 (17) High |
| Apgar score less than 7 at 5 minutes | 0.73 (0.56 to 0.96) | 13 per 1000 | 10 per 1000 (7 to 12) | 18 345 (20) Moderate |
| Caesarean section | 0.90 (0.85 to 0.95) | 186 per 1000 | 167 per 1000 (158 to 177) | 21 030 (31) Moderate |
| Operative vaginal birth (forceps or ventouse) | 1.03 (0.96 to 1.10) | 136 per 1000 | 140 per 1000 (131 to 150) | 18 584 (22) Moderate |