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BMC Pregnancy and Childbirth

, 15:276

First Online: 27 October 2015Received: 26 March 2015Accepted: 22 October 2015

Abstract

BackgroundInduction of labour is associated with increased risk for caesarean delivery among nulliparous women. The aims of this study were to evaluate the risk factors for caesarean delivery and to investigate the risk of maternal and neonatal infections in nulliparous women undergoing induction of labour by Foley catheter.

MethodsThis clinical retrospective study of 432 nulliparous women with singleton pregnancy and intact amniotic membranes at or beyond 37 gestational weeks scheduled for induction of labour by Foley catheter was conducted over the course of one year, between January 2012 and January 2013, in Helsinki University Hospital. The main outcome measures were caesarean section rate and maternal and neonatal infections. Univariate and multivariate logistic regressions were used to estimate relative risks by odds ratios with 95 % confidence intervals.

ResultsThe caesarean section rate was 39.1 % n = 169. In multivariate regression analysis, the factors associated with caesarean section were the need for oxytocin for labour induction OR 2.9 95 % CI 1.8-4.5 p < 0.001 and early epidural analgesia OR 9.9 95 % CI 2.1-47.5, p = 0.004. The maternal intrapartum infection rate was 6.3 %, and the clinical neonatal infection rate was 2.8 %. In multivariate analysis, gestational diabetes was associated with maternal intrapartum infection OR 4.3 95 % CI 1.7-11.0, p = 0.002 and early epidural analgesia with neonatal clinical sepsis OR 10.5 95 % CI 1.4-76, p = 0.02.

ConclusionsOxytocin induction and early epidural analgesia were associated with caesarean delivery. Gestational diabetes and early epidural analgesia were associated with infectious morbidity. Since the first caesarean delivery has a major impact on subsequent pregnancies, optimising labour induction among nulliparous women is important.

KeywordsInduction of labour Foley catheter Caesarean delivery rate Nulliparous Maternal infection Neonatal infection AbbreviationsIOLInduction of labour

GBSStreptococcus agalactie B

OROdds ratio

CIConfidence interval

IVFIn vitro fertilisation

BMIBody mass index

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