Rate of labor inductions on the decline

A recent report from the Centers for Disease Control and Prevention shows that the number of induced deliveries is on the decline after almost 20 years of increases. The data are taken from the Natality Data File from the National Vital Statistics System and represent births in singleton deliveries, which are the majority of newborns.

According to the report, the downtrend follows an increase in induced deliveries from 9.6% to an all-time high of 23.8% in 2010.  In 2011, the number of induced deliveries decreased to 23.7% and then again in 2012 to 23.3%. Induction rates decreased across all gestational age categories from 2010 through 2012 as well.

Grand Rounds: Detection and surveillance of IUGR

From 2006 to 2012, the induction rate at 38 weeks’ gestation declined for all maternal groups under age 40, with reductions ranging from 3% to 19%. The induction rate for late preterm births also declined, by 3% at 35 weeks and 7%, at 36 weeks. However, induction rates at 34 weeks increased from 15.9% in 2006 to 16.6% in 2010 and 2012, a 4% increase during the study period.

The decline in rates of induction at 38 weeks’ gestation held true across non-Hispanic whites, non-Hispanic blacks and Hispanics, at 19%, 3%, and 7%, respectively. At weeks 35, 36, and 37, however, reductions were seen only among non-Hispanic whites.  

Looking at induction rates on a state-by-state basis, the CDC researchers found that induction rates at 38 weeks fell in 36 states between 2006 and 2012. The declines ranged from 48% in Utah to 5% in Maryland. Five states had declines of 30%, whereas rates dropped by at least 10% in 31 states and the District of Columbia.

The authors noted that the trend in induction rates after 2006 is in keeping with a decline in overall rates of late preterm and early-term births. “Changes in induction of labor, particularly at 35-38 weeks,” they said, “may be associated with changes in obstetric practice, as research has demonstrated greater risks of morbidity and mortality among infants delivered these weeks compared with those delivered later in pregnancy.”

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