109 Birth. 2022;00:1–13. | 1 wileyonlinelibrary.com/journal/birt Received: 8 November 2021 | Revised: 17 January 2022 | Accepted: 10 February 2022 DOI: 10.1111/birt.12628 O R I G I NA L A RT I C L E Maternal characteristics as indications for routine induction of labor: A nationwide retrospective cohort study Bahareh Goodarzi RM, MSc1 | Anna Seijmonsbergen-Schermers RM, PhD1 | Maaike van Rijn RM2 | Neel Shah MD, PhD3 | Arie Franx MD, PhD4 | Ank de Jonge RM, PhD5 This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2022 The Authors. Birth published by Wiley Periodicals LLC. 1Department of Midwifery Science, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, AVAG, Amsterdam, the Netherlands 2Department of Obstetrics and Gynaecology, Haga Ziekenhuis, The Hague, The Netherlands 3Department of Obstetrics, Gynaecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts, USA 4Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, the Netherlands 5Department of Midwifery Science, Amsterdam Reproduction and Development, Amsterdam UMC, Vrije Universiteit Amsterdam, AVAG, Amsterdam, the Netherlands Correspondence Bahareh Goodarzi, RM, MSc, Department of Midwifery Science, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, AVAG, Van der Boechorststraat 7 1081 BT Amsterdam, the Netherlands. Email: b.goodarzi@amsterdamumc.nl Funding information The authors received no funding for this work Abstract Background: Maternal characteristics, such as parity and age, are increasingly considered indications for routine induction of labor of otherwise healthy women to prevent fetal and neonatal mortality. To fully balance the risks and benefits of induction of labor, we examined the association of additional relevant maternal characteristics and gestational age with fetal and neonatal mortality. Methods: We conducted a nationwide retrospective cohort study among a healthy Dutch population consisting of all singleton pregnancies in midwife-led care after 37 weeks of gestation in the period 2000-2018. We examined the association of maternal ethnicity, age, parity, and socioeconomic status with fetal and neonatal mortality, stratified by gestational age. The association of single characteristics was examined using descriptive statistics, and univariable and multivariable logistics regression analyses. The associations of multiple characteristics were examined using inter-categorical analyses and using interaction terms in the multivariable logistic regression analyses. Results: The results showed that ethnicity, age, parity, socioeconomic status, and gestational age did not act as single determinant of fetal and neonatal mortality. The probability of fetal and neonatal mortality differed among subgroups of women depending on which determinants were considered and the number of determinants included. Conclusions: Decision-making about induction of labor to prevent fetal and neonatal mortality based on a single determinant may lead to overuse or underuse of IOL. A value-based health care strategy, addressing social inequity, and investing in better screening and diagnostic methods that employ an individualized and multi-determinant approach may be more effective at preventing fetal and neonatal mortality. [Correction added on March 28, 2022, after first online publication: Figure 1 and 2 legends have been updated.]
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