MATERNAL AND NEONATAL OUTCOME FOLLOWING PROLONGED LABOR INDUCTION

Objective: To examine the effect of labor induction length on maternal and neonatal outcome. Methods: Inductions of labor were reviewed retr ospectively, comparing 27 patients with infectious complications to 31 3 with no infections. Univariate analysis, t-test, chi(2), and Fisher exact test were used for statistical analysis. Forward stepping logist ic regression was, used in a multivariate model to identify odds ratio (OR) and 95% confidence intervals (CI). Results: There was a statisti cally significant increased risk of maternal infection with increasing induction time. In univariate analysis, cesarean delivery, duration o f induction, duration of oxytocin administration, nulliparity, use of internal monitors, increased maternal weight gain, and low cervical di latation at start of induction were all associated with increased mate rnal infection risk. Multivariate analysis showed duration of inductio n for each additional 2 hours (OR 1.09; 95% CI 1.01, 1.18) and nonwhit e ethnicity (OR 5.95; 95% CI 1.72 20.49) to be associated significantl y with maternal infection. Maternal infection was associated with lowe r Apgar scores and increased neonatal intensive care unit admissions. In patients who delivered vaginally, a logistic regression model estim ated infectious morbidity at 40 hours to be 10%. The cesarean rate was not increased with prolonged induction. Conclusion: Prolonged inducti on is associated with a small increased risk of infectious morbidity, with an estimated 10% incidence noted after 40 hours of induction in w omen who deliver vaginally. (Obstet Gynecol 1998;92:403-7 (C) 1998 by The American College of Obstetricians and Gynecologists.)