MAKING pregnant women wait 42 weeks before inducing labour is putting unborn babies at risk, a study suggests.
Researchers say the NHS should offer inductions before 41 weeks to cut stillbirths or deaths in the first few days of life. They estimate one more baby could be saved for every 230 inductions done at this earlier stage.
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The medics, from Sahlgrenska University Hospital, Sweden, analysed data on 2,760 women with an uncomplicated, single pregnancy. They were randomly induced at 41 weeks or told to “wait and see” if the baby arrived later, with induction at 42 weeks if necessary.
The trial was stopped early after six babies died in the “wait and see” group, compared with none in the early induction group. Babies delivered early were also less likely to have a high birth weight, to suffer jaundice or to require intensive care. There were no differences in maternal health or the need for C-sections between the two groups.
Dr Ulla-Britt Wennerholm said: “We suggest that labour induction should be offered to women at 41 weeks or earlier and could be one of few interventions that reduces the rate of stillbirths.”
There were 604,000 births in England in 2018/19, of which one in three were induced, figures from NHS Digital show. Some 24,787 of these inductions were at 41 weeks and 6,705 at 42 weeks or later.
‘AVOID THE RISKS’
The NHS says a pregnancy is considered full-term when it reaches 37 weeks and women should be offered an induction beyond 41 weeks.
Prof Alexander Heazell, from the Royal College of Obstetricians and Gynaecologists, said: “The loss of a baby is a devastating tragedy for parents, to the wider family, and the healthcare professionals involved.
“The findings of this Swedish trial are in line with what is already known – that pregnancies that continue to, or pass, 41 weeks are usually safe and straightforward, but there is a small yet significant increase in stillbirth risk.
“Current UK guidance recommends that induction of labour should be offered to women with uncomplicated pregnancies who go beyond 41 weeks to avoid the risks of prolonged pregnancy, including stillbirth.
“We support the continual review of clinical guidelines as new evidence emerges to ensure best practice. 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.”
Commenting on the findings, Dr Sarah Stock, from the University of Edinburgh, said: “It now seems hard to justify denying women the option of induction of labour when they reach 41 weeks gestation.
“Maternity services must be adequately resourced and staffed to offer increasing numbers of induction of labour safely, in a setting that works for women.”
The findings are published in The British Medical Journal.
