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Factors and outcomes associated with the induction of labour in Latin America

  1. GV Guerra1,
  2. JG Cecatti1,
  3. JP Souza2,
  4. A Faúndes1,
  5. SS Morais1,
  6. AM Gülmezoglu2,
  7. MA Parpinelli1,
  8. R Passini Jr1,
  9. G Carroli3,
  10. for the World Health Organisation 2005 Global Survey on Maternal and Perinatal Health Research Group

Article first published online: 11 NOV 2009

DOI: 10.1111/j.1471-0528.2009.02348.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 116, Issue 13, pages 1762–1772, December 2009

Additional Information

How to Cite

Guerra, G., Cecatti, J., Souza, J., Faúndes, A., Morais, S., Gülmezoglu, A., Parpinelli, M., Passini Jr, R., Carroli, G. and for the World Health Organisation 2005 Global Survey on Maternal and Perinatal Health Research Group (2009), Factors and outcomes associated with the induction of labour in Latin America. BJOG: An International Journal of Obstetrics & Gynaecology, 116: 1762–1772. doi: 10.1111/j.1471-0528.2009.02348.x

Author Information

  1. 1

    Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil

  2. 2

    Department of Reproductive Health and Research, Human Reproduction Programme, World Health Organisation, Geneva, Switzerland

  3. 3

    Centro Rosarino de Estudios Perinatales – CREP, Rosario, Argentina

*JG Cecatti, PO Box 6030, 13083-881 Campinas – SP, Brazil. Email cecatti@unicamp.br

Publication History

  1. Issue published online: 11 NOV 2009
  2. Article first published online: 11 NOV 2009
  3. Accepted 18 July 2009.

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Keywords:

  • Labour induction;
  • mode of delivery;
  • perinatal outcome;
  • pregnancy complications

Objective  To describe the prevalence of labour induction, together with its risk factors and outcomes in Latin America.

Design  Analysis of the 2005 WHO global survey database.

Setting  Eight selected Latin American countries.

Population  All women who gave birth during the study period in 120 participating institutions.

Methods  Bivariate and multivariate analyses.

Main outcome measures  Indications for labour induction per country, success rate per method, risk factors for induction, and maternal and perinatal outcomes.

Results  Of the 97 095 deliveries included in the survey, 11 077 (11.4%) were induced, with 74.2% occurring in public institutions, 20.9% in social security hospitals and 4.9% in private institutions. Induction rates ranged from 5.1% in Peru to 20.1% in Cuba. The main indications were premature rupture of membranes (25.3%) and elective induction (28.9%). The success rate of vaginal delivery was very similar for oxytocin (69.9%) and misoprostol (74.8%), with an overall success rate of 70.4%. Induced labour was more common in women over 35 years of age. Maternal complications included higher rates of perineal laceration, need for uterotonic agents, hysterectomy, ICU admission, hospital stay >7 days and increased need for anaesthetic/analgesic procedures. Some adverse perinatal outcomes were also higher: low 5-minute Apgar score, very low birthweight, admission to neonatal ICU and delayed initiation of breastfeeding.

Conclusions  In Latin America, labour was induced in slightly more than 10% of deliveries; success rates were high irrespective of the method used. Induced labour is, however, associated with poorer maternal and perinatal outcomes than spontaneous labour.

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