Labor Induction For The Late Term Pregnancy And Its Safety: A Systematic Review With Meta-analysis

Objective: To systematically review and evaluate the impact on maternal-neonatal outcomes of labor induction for the late term pregnancy.Methods: A systematic review of the published studies including randomizedcontrolled trials of the late term pregnancy. Search engines including theCochrane Library, PubMed, Embase, CBMdisc, Google, CNKI, WANGFANGand WEIPU. Retrieval time was february2014. Recommendations have beenmade for input by following standardized guidelines developed by the ChildHealth Epidemiology Reference Group (CHERG), include heterogeneity, meta-analysis and meta-regression.Results: A total of9randomized controlled trials (RCTs) were included in thisreview. Meta-analysis suggests that: for the late term pregnancy, compared withwomen allocated to expectant management, those who underwent induced laborhad lower meconium stained amniotic fluid rate(18.18%versus25.05%, RR:0.69,95%CI:0.51-0.94, P=0.02) and lower meconium aspiration syndromerate(1.4%versus3.2%, RR:0.44,95%CI:0.23-0.86, P=0.02), these differenceswere statistically significant. On the other hand, no significant differences werenoted for cesarean delivery rates, birth asphyxia, NICU admission rates, perinataldeath or abnormal Apgar score.Conclusions: A policy of induced labor at or beyond41weeks gestation foruncomplicated singleton pregnancies did not increase the occur of cesareandelivery, neonatal asphyxia, perinatal mortality, perinatal complications. And caneffectively reduce the occur of meconium stained amniotic fluid and meconiumaspiration. Induced labor appears to be an effective way of improving pregnancyoutcome. It should be offered to women with the late term pregnancies afterdiscussing the benefits and risks of induced labor.