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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 26 Nov 2017
Modified on : 26 Nov 2017

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Bibliographical entry (without author) :

Racial/Ethnic Differences in Labor Outcomes with Prostaglandin Vaginal Inserts - Journal of racial and ethnic health disparities - Vol. 2, 2 - p.149-157

Author(s) :

Stephenson, M.L.; Hawkins, J.S.; Pevzner, L.; Powers, B.L.; Wing, D.A.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: The aim of this study is to compare labor outcomes across race/ethnicity in women undergoing prostaglandin labor induction.
METHODS: Secondary analysis of misoprostol vaginal insert (MVI) trial, a double-blind, randomized, control trial of 1,308 patients comparing sustained release vaginal inserts containing dinoprostone 10 mg and misoprostol 50 mcg (MVI 50) or 100 mcg (MVI 100).
RESULTS: Achievement of active labor and induction failures were similar across race/ethnicity. Cesareans were performed less frequently in whites (29 %) and Hispanics (24.5 %) compared to blacks (32.7 %) (adjusted odds ratio (aOR) 0.87, 95 % confidence interval (CI) 0.47-0.97, p = 0.03 and aOR 0.86, 95 % CI 0.44-0.97, p = 0.03, respectively). When compared to blacks, whites were less likely to undergo cesarean for non-reassuring fetal heart rate tracing (aOR 0.41, 95 % CI 0.25-0.66, p = 0.0003), as were Hispanics (aOR 0.38, 95 % CI 0.22-0.65, p = 0.0004). Postpartum hemorrhage occurred more frequently in Hispanics (8.8 %) versus blacks (4.1 %) and whites (OR 2.27, 95 % CI 0.23-0.82, p = 0.02 and OR 3.69, 95 % CI 0.14-0.51, p < 0.0001, respectively). Birth weights of black infants were lower than whites (p < 0.0001) and Hispanics (p = 0.0003). Neonatal outcomes did not differ between groups.
CONCLUSION: Differences in labor induction outcomes with prostaglandin labor induction exist based on race/ethnicity. Blacks delivered smaller babies, were more likely to undergo cesarean, and have cesareans performed for non-reassuring fetal heart tracing compared to other groups. Hispanics were more likely to experience postpartum hemorrhage compared to the other races.

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Keywords :

➡ induction of labor ; misoprostol (Cytotec)

Author of this record :

Import 26/11/2017 — 26 Nov 2017

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