Bulletin of the World Health Organization

Elective induction versus spontaneous labour in Latin America

Gláucia Virgínia Guerra, José Guilherme Cecatti, João Paulo Souza, Aníbal Faúndes, Sirlei Siani Morais, Ahmet Metin Gülmezoglu, Renato Passini, Mary Angela Parpinelli, Guillermo Carroli, for the WHO Global Survey on Maternal & Perinatal Health in Latin America Study Group

Volume 89, Number 9, September 2011, 657-665

Table 3. Crude relative risk (RR) and adjusted relative risk (RRadj) of specific maternal outcomes in women with low-risk pregnancies who underwent elective labour induction in selected Latin American countries, 2005

Maternal outcome Elective induction
 Spontaneous onset of labour
 RR (95% CI) RRadj (95% CI)a
No. % No. %
Mode of delivery
Vaginal 1629 88.25 32 506 91.35 1.0 1.0
Caesarean 217 11.75 3077 8.65 1.36 (1.19–1.55) 1.16 (1.00–1.35)
Missing 1 – 14 – – –
Postpartum haemorrhage with blood transfusion
No 1820 99.67 34 796 99.72 1.0 1.0
Yes 6 0.33 97 0.28 1.18 (0.52–2.69) 1.34 (0.58–3.09)
Missing 21 – 704 – – –
Need for uterotonics during postpartum period
No 1206 65.58 27 926 78.87 1.0 1.0
Yes 633 34.42 7483 21.13 1.63 (1.52–1.74) 1.52 (1.39–1.66)
Missing 8 – 188 – – –
Blood transfusion
No 1823 99.08 35 224 99.47 1.0 1.0
Yes 17 0.92 188 0.53 1.74 (1.06–2.85) 1.50 (0.91–2.47)
Missing 7 – 185 – – –
Perineal laceration
No 1827 99.40 35 184 99.52 1.0 1.0
Yes 11 0.60 171 0.48 1.24 (0.67–2.27) 1.46 (0.78–2.70)
Missing 9 – 242 – – –
Hysterectomy
No 1834 99.78 35 340 99.96 1.0 1.0
Yes 4 0.22 13 0.04 5.92 (1.93–18.13) 5.23 (1.62–16.86)
Missing 9 – 244 – – –
Admission to ICU
No 1838 99.67 35 491 99.83 1.0 1.0
Yes 6 0.33 61 0.17 1.90 (0.82–4.38) 2.90 (1.24–6.78)
Missing 3 – 45 – – –
Postpartum stay
< 7 days 1832 99.35 35 190 98.99 1.0 1.0
≥ 7 days 12 0.65 358 1.01 0.65 (0.36–1.15) 0.82 (0.46–1.45)
Missing 3 – 49 – – –
Anaesthesia during labour
No anaesthesia/analgesia 950 52.25 27 258 76.98 1.0 1.0
Epidural 332 18.18 3972 11.22 2.03 (1.48–2.24) 1.58 (1.40–1.79)
Spinal 29 1.59 337 0.95 2.42 (1.66–3.51) 1.28 (0.84–1.95)
Parenteral analgesic 341 18.67 2280 6.44 3.41 (3.09–3.77) 3.01 (2.65–3.41)
Alternative methods 170 9.31 1561 4.41 2.79 (2.41–3.23) 3.66 (3.12–4.29)
Missing 21 – 189 – – –
Status at discharge
Alive 1842 99.84 35 550 99.92 1.0 1.0
Dead 0 – 1 – – –
Referred to higher level 3 0.16 28 0.08 2.07 (0.63–6.79) 2.08 (0.62–6.96)
Missing 2 – 18 0.10 – –

CI, confidence interval; ICU, intensive care unit.

a Cox regression model with adjustment for mode of delivery and all predictors in Table 2 except body mass index.