{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:19:49Z","timestamp":1787930389230,"version":"build-2784847793"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The rate of induction of labor increased particularly after the publication of ARRIVE trial conducted in low-risk primiparous patients without medical indication. However, this increase of induction rate does not seem to concern this population alone. Our aim was to understand how induction rate have evolved according to its indications and the impact on cesarean rate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This was a retrospective observational study in a tertiary university maternity unit, including all women who gave birth between January 1st 2014 and December 31th 2021, at more than 24 weeks of gestation with a liveborn infant weighing\u2009\u2265\u2009500\u00a0g (<jats:italic>N<\/jats:italic>\u2009=\u20099,523). We described the frequency of induction and caesarean section per year within the maternity unit. We differentiated two study periods: 2014\u20132017 and 2018\u20132021. We used the Grenoble classification to analyse the contribution of each of group to the overall induction rate and calculated the absolute and relative difference in induction rate for each group between the two periods. We analysed changes in the risk of caesarean section in each of the groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The overall induction rate increased from 19.3 to 27.4% between 2014 and 2021 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The cesarean section rate for women who underwent induction decreased significantly from 29.5% in 2014 to 25.2% in 2021 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The induction rate moderately increased in the group corresponding to induction of labor \u201cwithout medical indication\u201d (relative difference of 14.9%; 95%CI [6.0;21.0]). The groups with the greatest increase in their induction rate between the two study periods were the breech group (relative difference of 66.7% 95%CI [49.0;83.0]) and the fetal pathology induction group (relative difference of 75.5% 95%CI [61.2;90.1]). The rate of cesarean among inducted women reduced significantly in the group of \u201cmultiple pregnancies\u201d (aOR\u2009=\u20090.6; 95%CI [0.4;0.9]) and in the group of \u201cmaternal pathologies\u201d (aOR\u2009=\u20090.8; 95%CI [0.6;0.9]). For the group 8 \u201cinduction without medical induction\u201d the reduction was not significant (aOR\u2009=\u20090.8; 95%CI [0.8;1.2]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>From 2014 to 2021, we observed a marked increase in the induction rate in our maternity unit. This increase was not associated with a change of the cesarean rate. Induction of labor without medical indication represent only a small part of the induction rate.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12884-025-07403-8","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T22:54:52Z","timestamp":1742943292000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does induction of labor without a medical indication explain the overall increase in the induction rate: an observational study before and after the ARRIVE trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Isabelle","family":"Attali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Cormier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille Le","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"issue":"10","key":"7403_CR1","doi-asserted-by":"crossref","first-page":"102509","DOI":"10.1016\/j.jogoh.2022.102509","volume":"51","author":"C Le Ray","year":"2022","unstructured":"Le Ray C, Lelong N, Cinelli H, Blondel B. Collaborators - Members of the ENP2021 study group. Results of the 2021 French National perinatal survey and trends in perinatal health in metropolitan France since 1995. J Gynecol Obstet Hum Reprod D\u00e9c. 2022;51(10):102509.","journal-title":"J Gynecol Obstet Hum Reprod D\u00e9c"},{"issue":"7","key":"7403_CR2","first-page":"CD004945","volume":"2020","author":"P Middleton","year":"2020","unstructured":"Middleton P, Shepherd E, Morris J, Crowther CA, Gomersall JC. Induction of labour at or beyond 37 weeks\u2019 gestation. Cochrane Database Syst Rev 15 Juill. 2020;2020(7):CD004945.","journal-title":"Cochrane Database Syst Rev 15 Juill"},{"key":"7403_CR3","doi-asserted-by":"crossref","unstructured":"Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G et al. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. N Engl J Med. 9 ao\u00fbt. 2018;379(6):513\u201323.","DOI":"10.1056\/NEJMoa1800566"},{"issue":"4","key":"7403_CR4","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ajog.2019.02.046","volume":"221","author":"WA Grobman","year":"2019","unstructured":"Grobman WA, Caughey AB. Elective induction of labor at 39 weeks compared with expectant management: a meta-analysis of cohort studies. Am J Obstet Gynecol Oct. 2019;221(4):304\u201310.","journal-title":"Am J Obstet Gynecol Oct"},{"issue":"1","key":"7403_CR5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/uog.20140","volume":"53","author":"A Sotiriadis","year":"2019","unstructured":"Sotiriadis A, Petousis S, Thilaganathan B, Figueras F, Martins WP, Odibo AO, et al. Maternal and perinatal outcomes after elective induction of labor at 39 weeks in uncomplicated Singleton pregnancy: a meta-analysis. Ultrasound Obstet Gynecol. 2019;53(1):26\u201335.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"7403_CR6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.bpobgyn.2021.12.007","volume":"79","author":"S Dong","year":"2022","unstructured":"Dong S, Bapoo S, Shukla M, Abbasi N, Horn D, D\u2019Souza R. Induction of labour in low-risk pregnancies before 40 weeks of gestation: A systematic review and meta-analysis of randomized trials. Best Pract Res Clin Obstet Gynaecol 1 Mars. 2022;79:107\u201325.","journal-title":"Best Pract Res Clin Obstet Gynaecol 1 Mars"},{"key":"7403_CR7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejogrb.2015.11.004","volume":"197","author":"KF Walker","year":"2016","unstructured":"Walker KF, Malin G, Wilson P, Thornton JG. Induction of labour versus expectant management at term by subgroups of maternal age: an individual patient data meta-analysis. Eur J Obstet Gynecol Reprod Biol 1 F\u00e9vr. 2016;197:1\u20135.","journal-title":"Eur J Obstet Gynecol Reprod Biol 1 F\u00e9vr"},{"issue":"8","key":"7403_CR8","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1111\/aogs.13561","volume":"98","author":"G Saccone","year":"2019","unstructured":"Saccone G, Della Corte L, Maruotti GM, Quist-Nelson J, Raffone A, De Vivo V, et al. Induction of labor at full-term in pregnant women with uncomplicated Singleton pregnancy: A systematic review and meta-analysis of randomized trials. Acta Obstet Gynecol Scand. 2019;98(8):958\u201366.","journal-title":"Acta Obstet Gynecol Scand"},{"key":"7403_CR9","doi-asserted-by":"crossref","unstructured":"Alkmark M, Keulen JKJ, Kortekaas JC, Bergh C, van Dillen J, Duijnhoven RG et al. Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials. PLoS Med. 8 d\u00e9c. 2020;17(12):e1003436.","DOI":"10.1371\/journal.pmed.1003436"},{"key":"7403_CR10","doi-asserted-by":"crossref","unstructured":"Fonseca MJ, Santos F, Afreixo V, Silva IS, Almeida M. do C. Does induction of labor at term increase the risk of cesarean section in advanced maternal age? A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 1 oct 2020;253:213\u20139.","DOI":"10.1016\/j.ejogrb.2020.08.022"},{"key":"7403_CR11","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s12884-022-04487-4","volume":"22","author":"M Vanneaux","year":"2022","unstructured":"Vanneaux M, Forey PL, Equy V, Hoffmann P, Riethmuller D. Induction of labour: creation of a classification of Grenoble allowing an assessment of the evaluation of practices. BMC Pregnancy Childbirth 21 F\u00e9vr. 2022;22:143.","journal-title":"BMC Pregnancy Childbirth 21 F\u00e9vr"},{"issue":"7","key":"7403_CR12","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1111\/aogs.13557","volume":"98","author":"T Gaillard","year":"2019","unstructured":"Gaillard T, Girault A, Alexander S, Goffinet F, Le Ray C. Is induction of labor a reasonable option for breech presentation? Acta Obstet Gynecol Scand. 2019;98(7):885\u201393.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"9987","key":"7403_CR13","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1016\/S0140-6736(14)61904-8","volume":"385","author":"M Boulvain","year":"2015","unstructured":"Boulvain M, Senat MV, Perrotin F, Winer N, Beucher G, Subtil D, et al. Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial. Lancet Juin. 2015;385(9987):2600\u20135.","journal-title":"Lancet Juin"},{"issue":"3","key":"7403_CR14","first-page":"273","volume":"220","author":"V Souter","year":"2019","unstructured":"Souter V, Painter I, Sitcov K, Caughey AB. Maternal and newborn outcomes with elective induction of labor at term. Am J Obstet Gynecol 1 Mars. 2019;220(3):273.e1-273.e11.","journal-title":"Am J Obstet Gynecol 1 Mars"},{"key":"7403_CR15","doi-asserted-by":"crossref","unstructured":"Boers KE, Vijgen SMC, Bijlenga D, van der Post Ja, Bekedam M, Kwee DJ. A, Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ 21 d\u00e9c 2010;341:c7087.","DOI":"10.1136\/bmj.c7087"},{"issue":"9694","key":"7403_CR16","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/S0140-6736(09)60736-4","volume":"374","author":"CM Koopmans","year":"2009","unstructured":"Koopmans CM, Bijlenga D, Groen H, Vijgen SM, Aarnoudse JG, Bekedam DJ, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks\u2019 gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet Lond Engl 19 Sept. 2009;374(9694):979\u201388.","journal-title":"Lancet Lond Engl 19 Sept"},{"key":"7403_CR17","unstructured":"HAS. D\u00e9clenchement artificiel du travail \u00e0 partir de 37 semaines d\u2019am\u00e9norrh\u00e9e. Recommandations pour la pratique clinique. Avril 2008. Retrieved from: https:\/\/www.has-sante.fr\/upload\/docs\/application\/pdf\/declenchement_artificiel_du_travail_-_argumentaire.pdf"},{"issue":"3","key":"7403_CR18","doi-asserted-by":"crossref","first-page":"S775","DOI":"10.1016\/j.ajog.2023.07.037","volume":"230","author":"E Azria","year":"2024","unstructured":"Azria E, Haaser T, Schmitz T, Froeliger A, Bouchghoul H, Madar H, et al. The ethics of induction of labor at 39 weeks in low-risk Nulliparas in research and clinical practice. Am J Obstet Gynecol 1 Mars. 2024;230(3):S775\u201382.","journal-title":"Am J Obstet Gynecol 1 Mars"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-025-07403-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12884-025-07403-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-025-07403-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T22:55:22Z","timestamp":1742943322000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-025-07403-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7403"],"URL":"https:\/\/doi.org\/10.1186\/s12884-025-07403-8","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,25]]},"assertion":[{"value":"15 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki. Under French regulations, this study is exempt from IRB review because it is an observational study using anonymized data from medical records. Women are informed that their records can be used for the evaluation of medical practices and are provided the option to opt out of these studies (agreement of National Data Protection Authority (Commission Nationale de l\u2019Informatique et des Libert\u00e9s, CNIL n\u00b01,755,849)). Human Ethics and Consent to Participate declarations are not applicable for this study in France.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"349"}}