Does Induction with Misoprostol Impact the Small for Gestational Age Neonate?

Megan E. Foeller, Meredith O. Cruz, Michelle A. Kominiarek, Judith U. Hibbard

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: To compare outcomes in small for gestational age neonates induced with misoprostol to other cervical ripening agents. We hypothesized that misoprostol use will demonstrate no significant difference in outcomes compared with alternative agents.

STUDY DESIGN: Small for gestational age neonates (<10th percentile for gestational age) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) sponsored Consortium on Safe Labor database were analyzed. Neonates induced with misoprostol ± oxytocin (n = 451) were compared with neonates induced with prostaglandin E2 ± oxytocin and/or mechanical dilation ± oxytocin (n = 663). Primary outcomes included intrapartum fetal distress, cesarean section for fetal distress, cesarean section for any reason, neonatal intensive care unit admission, low 5-minute Apgar, and composite neonatal morbidity. Multiple logistic regression was used to calculate adjusted odds ratios (aORs). Data were analyzed using SAS.

RESULTS: Small for gestational age neonates induced with misoprostol ± oxytocin compared with alternative agents had decreased low 5-minute Apgar scores (aOR 0.27 [0.10-0.71]). No significant differences were demonstrated among very small for gestational age neonates (<5th percentile for gestational age).

CONCLUSION: Our results suggest that misoprostol does not increase risk of adverse outcomes in small for gestational age neonates; however, prospective studies are warranted to further assess optimal cervical ripening agents in this population.

Original languageEnglish (US)
Pages (from-to)1311-1317
Number of pages7
JournalAmerican journal of perinatology
Volume32
Issue number14
DOIs
StatePublished - Dec 1 2015

Fingerprint

Misoprostol
Gestational Age
Cervical Ripening
Fetal Distress
Cesarean Section
National Institute of Child Health and Human Development (U.S.)
Apgar Score
Neonatal Intensive Care Units
Prostaglandins
Logistic Models
Odds Ratio
Databases
Prospective Studies
Morbidity
Population

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Foeller, Megan E. ; Cruz, Meredith O. ; Kominiarek, Michelle A. ; Hibbard, Judith U. / Does Induction with Misoprostol Impact the Small for Gestational Age Neonate?. In: American journal of perinatology. 2015 ; Vol. 32, No. 14. pp. 1311-1317.
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Does Induction with Misoprostol Impact the Small for Gestational Age Neonate? / Foeller, Megan E.; Cruz, Meredith O.; Kominiarek, Michelle A.; Hibbard, Judith U.

In: American journal of perinatology, Vol. 32, No. 14, 01.12.2015, p. 1311-1317.

Research output: Contribution to journalArticle

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N2 - OBJECTIVE: To compare outcomes in small for gestational age neonates induced with misoprostol to other cervical ripening agents. We hypothesized that misoprostol use will demonstrate no significant difference in outcomes compared with alternative agents.STUDY DESIGN: Small for gestational age neonates (<10th percentile for gestational age) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) sponsored Consortium on Safe Labor database were analyzed. Neonates induced with misoprostol ± oxytocin (n = 451) were compared with neonates induced with prostaglandin E2 ± oxytocin and/or mechanical dilation ± oxytocin (n = 663). Primary outcomes included intrapartum fetal distress, cesarean section for fetal distress, cesarean section for any reason, neonatal intensive care unit admission, low 5-minute Apgar, and composite neonatal morbidity. Multiple logistic regression was used to calculate adjusted odds ratios (aORs). Data were analyzed using SAS.RESULTS: Small for gestational age neonates induced with misoprostol ± oxytocin compared with alternative agents had decreased low 5-minute Apgar scores (aOR 0.27 [0.10-0.71]). No significant differences were demonstrated among very small for gestational age neonates (<5th percentile for gestational age).CONCLUSION: Our results suggest that misoprostol does not increase risk of adverse outcomes in small for gestational age neonates; however, prospective studies are warranted to further assess optimal cervical ripening agents in this population.

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