Affiliation:
1. The Ritchie Centre, Department of Obstetrics and Gynaecology Monash University Melbourne Victoria Australia
2. Safer Care Victoria, Department of Health Victorian Government Melbourne Victoria Australia
3. Department of Health Victorian Government Melbourne Victoria Australia
4. School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia
5. Department of Obstetrics and Gynaecology Royal Hospital for Women Sydney New South Wales Australia
Abstract
AimTo explore the association between induction of labour at full‐term gestations in low‐risk nulliparous women and childhood school outcomes.MethodsA retrospective whole‐of‐population cohort study linking perinatal data to educational test scores at grades 3, 5 and 7 in Victoria, Australia. Low‐risk nulliparous women with singleton pregnancies induced at 39 and 40 weeks without a medical indication were compared to those expectantly managed from that week of gestation. Multivariable logistic regressions were used as well as generalised estimating equations on longitudinal data.ResultsAt 39 weeks, there were 3687 and 103 164 infants in the induction and expectant arms, respectively. At 40 weeks' gestation, there were 7914 and 70 280 infants, respectively. Infants born to nulliparous women induced at 39 weeks' gestation had significantly poorer educational outcomes at grade 3 (adjusted odds ratio (aOR) = 1.39, 95% confidence interval (CI): 1.13–1.70) but not grades 5 (aOR = 1.05, 95% CI: 0.84–1.33) and 7 (aOR = 1.07, 95% CI: 0.81–1.40) compared to those expectantly managed. Infants born to nulliparous women induced at 40 weeks had comparable educational outcomes at grade 3 (aOR = 1.06, 95% CI: 0.90–1.25) but poorer educational outcomes at grades 5 (aOR = 1.23, 95% CI: 1.05–1.43) and 7 (aOR = 1.23, 95% CI: 1.03–1.47) compared to those expectantly managed.ConclusionsThere were inconsistent associations between elective induction of labour at full‐term gestations in low‐risk nulliparous women and impaired childhood school outcomes.
Funder
Norman Beischer Medical Research Foundation
Subject
Pediatrics, Perinatology and Child Health