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Inducing older first-time mums earlier reduces stillbirths

Inducing birth one or two weeks earlier in older first-time mothers could reduce the number of stillborn babies by two thirds, a study has found.

Current guidelines recommend induction be offered when the baby is one or two weeks late.

But the latest research – involving 80,000 women over 35 – found that when births were induced at the due date, normally the 40th week, it led to a large reduction in stillbirths.

The research by the London School of Hygiene and Tropical Medicine and University of Cambridge found inducing birth one to two weeks earlier would cut the rate of still birth from 26 per 10,000 pregnancies to 8 per 10,000, providing in the mothers were thought to be at low risk of complications.

The drawback to the finding is that inducing all women over 35 could create an ‘enormous’ impact on the cost of giving birth to the NHS, experts warn.

It means applying induction across the board to older mothers would prevent one stillbirth for every 562 inductions of labour.

The new research suggests current guidelines recommending induction be offered when the baby is one or two weeks late should be changed to on their due date (stock photo)

The new research suggests current guidelines recommending induction be offered when the baby is one or two weeks late should be changed to on their due date (stock photo)

Reducing complications

In 2015, 40,000 women aged 35 or older gave birth for the first time according to the Office for National Statistics.

The risk of risk of pregnancy complications, including stillbirth, while low, are higher for women having their first baby at age 35 or over.

Hannah Knight, the lead author, said: ‘The number of first-time mothers over the age of 35 is rising.

‘Although their risk of experiencing a stillbirth or neonatal death is relatively small, it’s still very important that these women receive the best advice on how to minimise the risks to themselves and their baby.

‘This study represents the strongest evidence yet that moving the offer of induction forward to 40 weeks might reduce the risk of stillbirth in this specific age group, which we know face a greater risk of stillbirth and neonatal death.’

Previous research has found that that induction of labour at 39 weeks of gestation has no short-term adverse effect on the mother or infant among pregnant women aged 35 years or older.

How the research was carried out 

In the latest study, the authors used data from English Hospital Episode Statistics covering 77,327 first time mothers aged 35 to 50 to determine whether the routine induction of labour earlier than recommended was associated with a change in risk to mother or child.

Induction of labour involves giving the mother a hormone – prostin – that triggers birth contractions. At present one in five of all births are induced.

The study compared rates of still birth and deaths shortly after birth between induction of labour at 39, 40 and 41 weeks of pregnancy.

Dr Knight said: ‘Whilst our study suggests bringing forward the routine offer of induction of labour to 40 weeks of gestation in first-time mums aged 35 or over may reduce the risk of perinatal death, there are other important factors to consider.

‘There are potential downsides to such a policy, such as acceptability of induction of labour to women and the increased demand on resources.

‘Further studies are needed to examine the impact of such a change in policy

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