{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:03:14Z","timestamp":1787752994954,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001840","name":"Icelandic Centre for Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001840","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Use of labor induction has increased rapidly in most middle\u2010 and high\u2010income countries over the past decade. The reasons for the stark rise in labor induction are largely unknown. We aimed to assess the extent to which the rising rate of labor induction is explained by changes in rates of underlying indications over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The study was based on nationwide data from the Icelandic Medical Birth Register on 85\u2009620 singleton births from 1997 to 2018. The rate of labor induction and indications for induction was calculated for all singleton births in 1997\u20132018. Change over time was expressed as relative risk (RR), using Poisson regression with 95% confidence intervals (CI) adjusted for maternal characteristics and indications for labor induction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The crude rate of labor induction rose from 12.5% in 1997\u20132001 to 23.9% in 2014\u20132018 (crude RR\u00a0=\u00a01.91, 95% CI 1.81\u20132.01). While adjusting for maternal characteristics had little impact, adjusting additionally for labor induction indications lowered the RR to 1.43 (95% CI 1.35\u20131.51). Induction was increasingly indicated from 1997\u20132001 to 2014\u20132018 by gestational diabetes (2.4%\u201316.5%), hypertensive disorders (7.0%\u201311.1%), prolonged pregnancy (16.2%\u201323.7%), concerns for maternal wellbeing (3.2%\u20136.9%) and maternal age (0.5%\u20131.2%). No indication was registered for 9.2% of inductions in 2014\u20132018 compared with 16.3% in 1997\u20132001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results show that the increase in labor induction over the study period is largely explained by an increase in various underlying conditions indicating labor induction. However, indications for 9.2% of labor inductions remain unexplained and warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14447","type":"journal-article","created":{"date-parts":[[2022,9,17]],"date-time":"2022-09-17T06:40:20Z","timestamp":1663396820000},"page":"1422-1430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Trends in labor induction indications: A 20\u2010year population\u2010based study"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9476-130X","authenticated-orcid":false,"given":"Emma M.","family":"Swift","sequence":"first","affiliation":[{"name":"Faculty of Nursing and Midwifery University of Iceland  Reykjavik Iceland"},{"name":"Reykjavik Birth Center  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Gunnarsdottir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center of Public Health Sciences University of Iceland  Reykjavik Iceland"},{"name":"Department of Obstetrics and Gynecology Landspitali \u2010 The National University Hospital of Iceland  Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0761-9028","authenticated-orcid":false,"given":"Helga","family":"Zoega","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center of Public Health Sciences University of Iceland  Reykjavik Iceland"},{"name":"Faculty of Medicine and Health, School of Population Health University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-1319","authenticated-orcid":false,"given":"Ragnheidur I.","family":"Bjarnadottir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Landspitali \u2010 The National University Hospital of Iceland  Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8161-173X","authenticated-orcid":false,"given":"Thora","family":"Steingrimsdottir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Landspitali \u2010 The National University Hospital of Iceland  Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-7650","authenticated-orcid":false,"given":"Kristjana","family":"Einarsdottir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center of Public Health Sciences University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13299"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12353"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12564"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2018.08.168"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800566"},{"key":"e_1_2_10_7_1","first-page":"1","article-title":"Swepis har lett till \u00f6verilade \u00e4ndringar i f\u00f6rlossningsrutiner \u2010 Befogat att avbryta studien i f\u00f6rtid, men forskningen b\u00f6r granskas i sin helhet innan slutsatser dras och rutiner \u00e4ndras [SWEPIS has led to rash changes in routines within Swedish obstetric care]","volume":"117","author":"Drevin J","year":"2020","journal-title":"Lakartidningen"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6131"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61998-X"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60736-4"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902430"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00169.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228196"},{"key":"e_1_2_10_15_1","unstructured":"Excellence NifC.Induction of labour. 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