Presentation (CTI)

OBJECTIVES: This descriptive analysis used data from the Danish Medical Birth Register and National Patient Register (2015/2021).
This study examines how age, BMI, and parity influence the proportion of cesareans, instrumental births, and other labour outcomes between induction methods and no induction.
METHODS: Induction with the prostaglandin (PG) misoprostol, membrane rupture (MR) with PG, other induction methods, premature MR combined with PG, and other induction methods combined with PG, were compared to non-induced labour. These results focus on the three first methods and no induction. Outcome in terms of caesarean, instrumental birth and neonatal mortality were stratified by age, BMI, and parity.
RESULTS: No induction showed highest proportions of caesarean, lowest proportions were seen using misoprostol. For non-induced labour, caesareans increased with parity while for induced labour no trend was observed. Instrumental births decreased with age, BMI, and parity in all groups except misoprostol and MR + PG where no age-related trend was identified. Some induction methods are used in delivery following intrauterine death, which is reflected in increased neonatal mortality. Highest neonatal mortality was observed with misoprostol followed by non-induced birth, MR + PG and other induction methods.
CONCLUSIONS: High age, BMI, and parity are associated with increased caesarean rates. Induced labour exhibited lower proportions of caesarean sections compared to non-induced births. Misoprostol is used to induce birth following intrauterine death, as indicated by the register holder, and was therefore associated with highest neonatal mortality. Births induced with MR + PG exhibit low neonatal mortality, supporting that higher incidence in the misoprostol group is related to clinical practice for delivering stillborn babies. Further stratified analysis is needed to fully assess neonatal outcomes.