Feto-maternal outcomes among women undergoing labor induction versus spontaneous labor in late-term and post-term pregnancies at Jaramogi Oginga Teaching And Referral Hospital, Kisumu

Abstract

Late-term and post-term pregnancies are associated with an increased risk of adverse maternal and neonatal outcomes, including perinatal mortality. The World Health Organization recommends induction of labor at 41 weeks for low-risk pregnancies because continuing the pregnancy beyond this period may increase the likelihood of complications. These risks are particularly important in low-income settings, including sub-Saharan Africa, where late-term and post-term pregnancies remain common and local evidence on their management is limited. This study compared maternal and neonatal outcomes among women with late-term and post-term pregnancies who underwent induction of labor with those who experienced spontaneous labor.The study examined the sociodemographic characteristics, maternal outcomes and neonatal outcomes of the two groups. A prospective cohort design was used, involving 244 women with pregnancies of at least 41 weeks of gestation. Data were collected using a structured questionnaire and analysed using Stata version 17.The two groups were comparable in terms of age, education, employment, marital status and place of residence. However, parity differed significantly between the groups. Women with parity of two or less accounted for 89.6% of the induction group compared with 71.4% of the spontaneous-labor group (p = 0.001). The need for additional oxytocin augmentation was significantly higher among women in the induction group than among those in the spontaneouslabor group (41.6% versus 28.6%, p = 0.033). Postpartum haemorrhage occurred in 11.2% of women in the induction group compared with 3.4% in the spontaneous-labor group (p = 0.026). Caesarean delivery rates did not differ significantly between the groups (p = 0.681). Neonatal outcomes, including five-minute Apgar scores, birth weight, admission to the neonatal intensive care unit and perinatal mortality, were also comparable between the groups.In conclusion, induction of labor among women with late-term and post-term pregnancies at Jaramogi Oginga Odinga Teaching and Referral Hospital was associated with a greater need for oxytocin augmentation and a higher occurrence of postpartum haemorrhage. Immediate neonatal outcomes were comparable to those observed among women who experienced spontaneous labor. These findings highlight the need for appropriate counselling, close monitoring during induction and adequate preparedness for oxytocin augmentation and the prevention and management of postpartum haemorrhage.