For late pregnancies, starting labor at 41 weeks may be safer than waiting until week 42, an extensive Swedish study suggests.
The randomized tests across 14 hospitals were stopped early because stillbirths and newborn death had been considerably higher with “expectant management” until the 42nd week of pregnancy in comparison with beginning labor at 41 weeks, the doctors report in The BMJ.
There have been no other differences between the two teams in adverse results for infants or mothers, so induction at 41 weeks should be provided to moms, the research team concludes.
Around 14% of stillbirths are associated with extended pregnancy worldwide, the study authors note in their research. The World Health Organization suggests induction at 41 weeks, but nations usually differ in their actions.
Wennerholm and colleagues analyzed the induction of labor at 41 weeks with a “wait and see” strategy and induction at 42 weeks if labor had still not taken place. At 14 hospitals in Sweden, during 2016-2018, a total of 2,760 women with low-risk, uncomplicated pregnancies lasting over 40 weeks had been randomly assigned to one of the two teams.
The researchers observed a composite of adverse results for the infant, including stillbirth, neonatal death, brain hemorrhage, oxygen deprivation, disturbed breathing, convulsions, and needed ventilation. They also checked out complications for mothers, including cesarean delivery or vaginal beginning with instruments, extended labor, use of epidural anesthesia, and hemorrhage.
The study group had planned to recruit 10,000 women over time, however, they cut the trial short after they noticed a considerably higher rate of infant mortality in the expectant management team. There have been five stillbirths and one neonatal death among the women who waited until week 42, compared with none in the group began at 41 weeks.