Inducing labour for women still pregnant at 41 weeks could lower stillbirth rate, study suggests

Experts say post-term pregnancies have 'small yet significant increase in stillbirth risk'

Sarah Young
Thursday 21 November 2019 10:44

Inducing labour for women whose pregnancy continues to 41 weeks could help lower the number who experience stillbirth, new research suggests.

Currently, NHS practice states that induction should be offered to all women who don’t go into labour naturally by 42 weeks.

However scientists in Sweden are now disputing the rule and claiming it should be reduced to 41 weeks to help cut the risk of complications and baby loss.

The call follows a trial of 2,760 women with an uncomplicated, single pregnancy who were admitted to 14 Swedish hospitals between 2016 and 2018.

The researchers involved in the study, which has been published in the British Medical Journal, compared the “wait and see” approach with inductions offered for pregnancies at 41 weeks, measuring for an outcome that included factors such as low oxygen levels and breathing problems.

This was experienced at similar rates in both groups, including 33 women who were induced at 41 weeks and by 31 women in the group that waited.

However six babies in the “wait and see” group died compared with none in the induction group, so the trial was stopped prematurely.

The deaths included five stillbirths and one early neonatal death.

The authors concluded that while differences in hospital policies and practices could have affected the results, women with low-risk pregnancies should be offered inductions “no later” than at 41 weeks.

They added that the update “could be one of few interventions that reduces stillbirth” and estimated that for every 230 women induced at 41 weeks, one perinatal death would be prevented.

The researchers also stated that there was a lower admittance to a neonatal intensive care unit in the group induced at 41 weeks.

Speaking of the findings, Sara Kenyon, professor of evidence based maternity care at the University of Birmingham, said that induction at 41 weeks “looks like the safer option for women and their babies”.

“Choice is important within maternity care, and clear information about available options should be accessible to all pregnant women, enabling them to make fully informed and timely decisions,” Kenyon said.

Professor Alexander Heazell, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists, agreed that pregnancies which continue to, or pass, 41 weeks have a “small yet significant increase in stillbirth risk”.

“We are saddened by reports of babies who died during a research trial in Sweden,” Heazell said.

“The loss of a baby is a devastating tragedy for parents, to the wider family, and the healthcare professionals involved.

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“We support the continual review of clinical guidelines as new evidence emerges to ensure best practice.”

Heazell continued: “A woman’s individual needs and preferences should always be taken into account and they must have the opportunity to make informed decisions in partnership with their healthcare professionals.”

You can find out more information regarding the induction of labour compared with staying pregnant here.

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