{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T23:12:22Z","timestamp":1784589142759,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Most observational studies found that non\u2010medically indicated induction of labor (IOL) is not associated with an increased risk of cesarean delivery compared with expectant management, defined as all births at a later gestation. However, given the higher rate of cesarean delivery at late term, this definition of the expectant management group might bias the results of observational studies in favor of IOL at early or full term when estimating the risk of short\u2010term (eg up to 1\u00a0week) expectant management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We conducted a retrospective cohort study including 447\u00a0066 singleton term and post\u2010term hospital births that occurred in Austria between 2008 and 2016. Multivariate logistic regression was used to test the association of IOL and cesarean delivery at each week of gestation from 37\u201041. Expectant management was either defined as all births at \u201cnext week or beyond\u201d or \u201cat next week\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Non\u2010medically indicated IOL was associated with increased odds for cesarean delivery at 37 and 38\u00a0weeks, and reduced odds at 40 and 41\u00a0weeks. At 39\u00a0weeks, IOL resulted in comparable cesarean rates compared with expectant management defined as \u201cnext week or beyond\u201d (17.2% vs 16.2%; adjusted odds ratio [OR] 0.93; 95% confidence interval [CI] 0.86\u20101.00; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.059). However, when defined as births \u201cat the next week\u201d, expectant management was associated with significantly reduced odds for cesarean delivery (13.6%; adjusted OR 0.76; 95% CI 0.70\u20100.82; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Comparison of the cesarean delivery rates for the two definitions of expectant management showed that the \u201cnext week and beyond\u201d model underestimates the benefit of short\u2010term expectant management by up to 1\u00a0week, particularly for IOL at weeks 38 and 39.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings demonstrate that the definition of the expectant management group has a significant impact when analyzing the outcome of IOL in retrospective cohort studies. Non\u2010medically indicated IOL is not an all\u2010or\u2010none choice between \u201celective\u201d induction and indefinite expectant management. Thus, to define the control group as all births at the next week could be useful for clinical decision\u2010making, as it allows to estimate the risks of expectant management until the next appointment compared with immediate IOL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13989","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T13:32:30Z","timestamp":1599139950000},"page":"220-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cesarean delivery after non\u2010medically indicated induction of labor: A population\u2010based study using different definitions of expectant management"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1609-772X","authenticated-orcid":false,"given":"Christoph","family":"Zenzmaier","sequence":"first","affiliation":[{"name":"University of Applied Sciences Tyrol Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Tyrolean Federal Institute for Integrated Care Tirol Kliniken Innsbruck Austria"},{"name":"Austrian Institute of Technology Digital Health Information Systems Hall in Tirol Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Leitner","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Tyrolean Federal Institute for Integrated Care Tirol Kliniken Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"K\u00f6nig\u2010Bachmann","sequence":"additional","affiliation":[{"name":"University of Applied Sciences Tyrol Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,24]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Institut f\u00fcr klinische Epidemiologie Teil des Landesinstituts f\u00fcr Integrierte Versorgung Tirol.Geburtenregister \u00d6sterreich. Bericht \u00fcber die Geburtshilfe in \u00d6sterreich 2018. [Birth register Austria. Report on obstetrics in Austria 2018.] In German. State Institute for Integrated Care Tyrol; Innsbruck 2019."},{"key":"e_1_2_9_3_1","first-page":"235","article-title":"Elective induction vs spontaneous labor associations and outcomes","volume":"50","author":"Glantz JC","year":"2005","journal-title":"J Reprod Med"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.01.051"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01298.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00007"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-017-4354-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.016"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a6a4d0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.06.054"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.07.003"},{"key":"e_1_2_9_12_1","first-page":"CD004945","article-title":"Induction of labour for improving birth outcomes for women at or beyond term","volume":"5","author":"Middleton P","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800566"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.046"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13561"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-321"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-35535"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2018.04.425"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.223"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12576"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01160.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e2838"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.05.004"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/JPN.0b013e31826288a9"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000031"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000114"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000029"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181c4ef96"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1812323"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003342"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12275"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13989","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13989","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T11:44:40Z","timestamp":1693741480000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,24]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/aogs.13989"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13989","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,24]]},"assertion":[{"value":"2020-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}