ARRIVE

Does elective induction of labor during the 39th week of pregnancy result in a lower rate of death and serious complications for babies compared to waiting until at least 40 weeks and 5 days for elective induction?

Study design: Randomized controlled trial

Population

Number of patients studied: 6,106
Inclusion criteria: First-time mothers with a single, head-down baby and no major medical conditions
Exclusion criteria: Multiple pregnancies, breech presentation, major medical conditions

Interventions

Experimental group: Induction at 39 weeks
Control group: Expectant management (waiting for labor to begin on its own, inducing for medical reasons, or inducing electively after 40 weeks and 5 days)

Primary outcome

Rate of death or serious complications for babies

Significant difference? No

Secondary outcomes

Lower Cesarean rate in the experimental group (19%) compared to the control group (22%)
Lower rate of pregnancy-induced high blood pressure in the experimental group (9%) compared to the control group (14%)

Conclusion

Elective induction at 39 weeks did not improve the primary outcome of death or serious complications for babies but was associated with a lower rate of Cesarean sections and a lower chance of developing pregnancy-induced high blood pressure.

Grobman, W. A., Rice, M. M., Reddy, U. M., Tita, A. T., Silver, R. M., Mallett, G., ... & Chien, E. K. (2018). Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. New England Journal of Medicine, 379(6), 513-523.