The impact of duration of labor induction on cesarean rate

Kenneth A. Michelson, Darcy B. Carr, Thomas R. Easterling*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective: We sought to determine maternal factors that influence success of labor induction and whether the probability of cesarean delivery changed with time during induction. Study Design: We performed a retrospective cohort study of 1650 singleton pregnancies induced at a gestation of 37 weeks or longer, with birthweights of 2500 g or greater, and without congenital anomalies. We used multivariate logistic regression to calculate odds ratios for cesarean. Results: Nulliparity (odds ratio [OR] 7.8, 95% confidence interval [CI] 5.7 to 11), hypertension (OR 1.4, 95% CI 1.1 to 1.8), diabetes (OR 2.2, 95% CI 1.6 to 3.1), maternal age 28.8 years old or older (OR 1.3, 95% CI 1.2 to 1.4), and birthweight of 3441 g or greater (OR 1.6, 95% CI 1.2 to 2.0) were significantly associated with cesarean. Cesarean risk increased linearly with time by an average of 3.8% per 6 hours. Conclusion: Risk of cesarean increases over the duration of induction but does not reach clinical certainty. Cesarean probability is greater with nulliparity, hypertension, diabetes, older maternal age, or higher birthweight. Inductions without stated indications may not carry an increased risk of cesarean.

Original languageEnglish (US)
Pages (from-to)299.e1-299.e4
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Sep 2008


  • cesarean rate
  • labor induction
  • obstetrics epidemiology

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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