Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.

<h4>Background</h4>Labour induction should be performed where benefit outweighs potential harm, however epidemiology of induction in lower-income countries is not well described. We used the WHO Global Survey dataset to describe the epidemiology and outcomes of labour induction in 192,53...

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Autores principales:	Joshua P Vogel, João Paulo Souza, A Metin Gülmezoglu
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/773b6d5fb49b48e29f016721e0a1a29f
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spelling	oai:doaj.org-article:773b6d5fb49b48e29f016721e0a1a29f2021-11-18T07:43:11ZPatterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.1932-620310.1371/journal.pone.0065612https://doaj.org/article/773b6d5fb49b48e29f016721e0a1a29f2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23755259/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Labour induction should be performed where benefit outweighs potential harm, however epidemiology of induction in lower-income countries is not well described. We used the WHO Global Survey dataset to describe the epidemiology and outcomes of labour induction in 192,538 deliveries in 253 facilities across 16 countries in Africa and Asia.<h4>Methods</h4>Data was analyzed separately for Africa and Asia. Prevalence of indications, methods, success and characteristics associated with labour induction were determined. Multilevel logistic regression was used to determine the relationship between induction (with medical indication and elective) and maternal/perinatal outcomes.<h4>Results</h4>Induction accounted for 4.4% (Africa) and 12.1% (Asia) of deliveries. Oxytocin alone was the most common method (45.9% and 37.5%) and success rates were generally over 80%. Medically indicated inductions were associated with increased adjusted odds of Apgar <7 at 5 minutes, low birthweight, NICU admission and fresh stillbirth in both regions. The odds of caesarean section in Africa were reduced (Adj OR 0.61, 95%CI 0.42-0.88). Elective induction was associated with increased adjusted odds of NICU (Africa) and ICU (Asia) admissions.<h4>Discussion</h4>Induction was generally less common than in higher-income countries. Prostaglandin use was uncommon despite evidence supporting use. Induction for medical indications may be associated with poorer outcomes due to maternal baseline risks. Despite one-third of elective inductions occurring at <39 weeks, the risk of maternal, fetal and neonatal mortality was not elevated following elective inductions.Joshua P VogelJoão Paulo SouzaA Metin GülmezogluPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e65612 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joshua P Vogel João Paulo Souza A Metin Gülmezoglu Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
description	<h4>Background</h4>Labour induction should be performed where benefit outweighs potential harm, however epidemiology of induction in lower-income countries is not well described. We used the WHO Global Survey dataset to describe the epidemiology and outcomes of labour induction in 192,538 deliveries in 253 facilities across 16 countries in Africa and Asia.<h4>Methods</h4>Data was analyzed separately for Africa and Asia. Prevalence of indications, methods, success and characteristics associated with labour induction were determined. Multilevel logistic regression was used to determine the relationship between induction (with medical indication and elective) and maternal/perinatal outcomes.<h4>Results</h4>Induction accounted for 4.4% (Africa) and 12.1% (Asia) of deliveries. Oxytocin alone was the most common method (45.9% and 37.5%) and success rates were generally over 80%. Medically indicated inductions were associated with increased adjusted odds of Apgar <7 at 5 minutes, low birthweight, NICU admission and fresh stillbirth in both regions. The odds of caesarean section in Africa were reduced (Adj OR 0.61, 95%CI 0.42-0.88). Elective induction was associated with increased adjusted odds of NICU (Africa) and ICU (Asia) admissions.<h4>Discussion</h4>Induction was generally less common than in higher-income countries. Prostaglandin use was uncommon despite evidence supporting use. Induction for medical indications may be associated with poorer outcomes due to maternal baseline risks. Despite one-third of elective inductions occurring at <39 weeks, the risk of maternal, fetal and neonatal mortality was not elevated following elective inductions.
format	article
author	Joshua P Vogel João Paulo Souza A Metin Gülmezoglu
author_facet	Joshua P Vogel João Paulo Souza A Metin Gülmezoglu
author_sort	Joshua P Vogel
title	Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
title_short	Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
title_full	Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
title_fullStr	Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
title_full_unstemmed	Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.
title_sort	patterns and outcomes of induction of labour in africa and asia: a secondary analysis of the who global survey on maternal and neonatal health.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/773b6d5fb49b48e29f016721e0a1a29f
work_keys_str_mv	AT joshuapvogel patternsandoutcomesofinductionoflabourinafricaandasiaasecondaryanalysisofthewhoglobalsurveyonmaternalandneonatalhealth AT joaopaulosouza patternsandoutcomesofinductionoflabourinafricaandasiaasecondaryanalysisofthewhoglobalsurveyonmaternalandneonatalhealth AT ametingulmezoglu patternsandoutcomesofinductionoflabourinafricaandasiaasecondaryanalysisofthewhoglobalsurveyonmaternalandneonatalhealth
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Patterns and Outcomes of Induction of Labour in Africa and Asia: a secondary analysis of the WHO Global Survey on Maternal and Neonatal Health.

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