{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:12:46Z","timestamp":1747149166794,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011103","name":"Rann\u00eds","doi-asserted-by":"publisher","award":["ID: 195900\u2010051"],"award-info":[{"award-number":["ID: 195900\u2010051"]}],"id":[{"id":"10.13039\/501100011103","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Labor induction is offered to reduce the risk of stillbirth at late term (41<jats:sup>+0<\/jats:sup> to 41<jats:sup>+6<\/jats:sup>) but earlier induction in normotensive singleton pregnancies is supported by weak evidence. The aim of the present study was to investigate the optimal timing for induction in normotensive women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study including 70\u2009293 singleton term births in Iceland during 1997\u20132018. Women with serious pre\u2010gestational comorbidity, hypertension, stillbirth or previous cesarean birth were excluded. The risk of adverse maternal and neonatal outcomes for induction at each week from gestational age 37\u201341\u2009weeks was compared with expectant management, defined as deliveries at a later gestational age. Risk ratios (RRs) and 95% confidence intervals (95% CI) were calculated using log\u2010binomial regression adjusting for sociodemographics, parity, and pregnancy complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The risk of cesarean was lower with induction at \u226540<jats:sup>+0<\/jats:sup> than expectant management, especially at late term (RR 0.73, 95% CI: 0.63\u20130.83). Respiratory distress was diagnosed in 4.4% of infants after induction from 37<jats:sup>+0<\/jats:sup> to 37<jats:sup>+6<\/jats:sup> but 1.3% in the expectant management group (RR 3.08, 95% CI: 1.97\u20134.81). Induction between 37<jats:sup>+0<\/jats:sup> and 38<jats:sup>+6<\/jats:sup> compared with expectant management was associated with a reduced risk of shoulder dystocia, but this was non\u2010significant in births of infants with normal birthweight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Labor induction from 40<jats:sup>+0<\/jats:sup> compared with expectant management was associated with reduced risk of cesarean birth in Icelandic women without an increase in risk of adverse maternal or neonatal outcomes. No additional benefit appeared to be from inducing at earlier gestations in low\u2010risk pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16050","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T11:45:08Z","timestamp":1732189508000},"page":"365-371","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal timing for induction of labor in normotensive women: A retrospective cohort study"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2989-7160","authenticated-orcid":false,"given":"J\u00f3hanna","family":"Gunnarsd\u00f3ttir","sequence":"first","affiliation":[{"name":"Center of Public Health Sciences, Faculty of Medicine University of Iceland  Reykjavik Iceland"},{"name":"Department of Obstetrics and Gynecology Landspitali\u2014The National University Hospital of Iceland  Reykjavik 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