Meta Analysis for the Clinical Evidence of Labor Induction

Objective To systematically review and evaluate the post-term pregnancy and premature rupture of membrane as indications for induction of labor. Methods Searched databases including the Cochrane Library, PubMed, EMBASE, CBMdisc, VIP, CNKI and WANGFANG to assemble the RCT of post-term pregnancy and premature rupture of membrane. Retrieval time was October 2011. The RevMan5.0 software was used for data analysis. Results For post-term pregnancy, compared with women allocated to expectant management, those who underwent labor induction had lower meconium staining rate （22.7% vs. 28.2%, OR 0.75, 95%CI 0.66~0.84, P=0.02）. Although subjects whose labor was induced experienced a lower perinatal mortality rate （0.09% vs. 0.33%, OR 0.41, 95%CI 0.77~1.18）, this difference was not statistically significant. Similarly, no significant differences were noted for NICU admission rates, meconium aspiration, or abnormal Apgar’s score. For premature rupture of membrane, medical induction compared with expectant management, significantly increased vaginal delivery within 12 hours（RR 0.54, 95%CI 0.43~0.67, P<0.001）. Induction of labor was not associated with an increased risk of abnormal uterine contraction and had similar risk for adverse neonatal and maternal outcomes. Conclusions Research is needed to determine risks and benefits of induction for many commonly advocated clinical indications.