Feto-Maternal Outcomes in Induced and Spontaneous Labor among Term Primigravida in a Tertiary Care Hospital

Abstract

Background: Induction of labor is a common obstetric intervention performed to improve maternal and neonatal outcomes in term pregnancy. However, concerns remain regarding its association with adverse feto-maternal outcomes compared with spontaneous labor, particularly among  primigravida women.

Objective: To compare the feto-maternal outcomes between induced and spontaneous labor among term primigravida admitted in a tertiary care hospital. Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Chattogram Medical College Hospital, from March 2018 to February 2019. A total of 130 term primigravida women were purposively enrolled and equally divided into spontaneous labor (n=65) and induced labor (n=65) groups. Socio-demographic characteristics, mode of delivery, duration of labor, maternal complications, and neonatal outcomes were recorded using a structured data collection sheet. Data were analyzed using SPSS version 27. Student’s t-test and Chi-square test were used for comparison of continuous and categorical variables, respectively. A p-value <0.05 was considered statistically significant.

Results: The mean age of participants was similar between the spontaneous and induced labor groups (20.26±1.11 vs 20.14±1.03 years; p=0.513). Mean gestational age and BMI were significantly higher in the induced labor group (41.61±0.48 weeks and 24.07±1.32 kg/m²) than in the spontaneous labor group (41.21±0.01 weeks and 22.63±1.55 kg/m²) (p<0.001). Normal vaginal delivery was more frequent in the spontaneous labor group (86.2%) compared to the induced labor group (78.5%), while caesarean section rates were 9.2% and 12.3%, respectively. The mean duration of the first stage of labor was significantly shorter in the induced labor group (7.59±0.85 hours) than in the spontaneous labor group (10.53±1.04 hours) (p<0.001). Maternal complications, including atonic  postpartum hemorrhage, cervical tear, and perineal tear, showed no significant difference between groups. Neonatal outcomes such as birth asphyxia, meconium aspiration, NICU admission, and Apgar scores at 1 and 5 minutes were also comparable between the two groups (p>0.05).

Conclusion: Induced labor among term primigravida showed comparable maternal and neonatal outcomes to spontaneous labor without significant increase in adverse feto-maternal complications or caesarean delivery rates.

J Shaheed Suhrawardy Med Coll 2025; 17(1): 73-77