{
    "abstract": "Induction of labor is a common procedure, and in Denmark, approximately one in four vaginal deliveries are induced. The association between induction and maternal postpartum infections such as endometritis, surgical site infection after cesarean section, urinary tract infection, and sepsis has been sparsely investigated. Our objective was to investigate the association between induction of labor and risk of maternal postpartum infection and to identify potential risk factors for infection.\nIn a nationwide cohort study, all deliveries with live-born singletons from January 1, 2007, to December 31, 2017 (n\u2009=\u2009546\u2009864) were included. Deliveries were grouped into categories of spontaneous onset of labor, induction of labor, and elective cesarean section. The primary outcome was any infection within 30\u2009days postpartum based on discharge diagnosis codes and redeemed antibiotic prescriptions for endometritis, surgical site infection, urinary tract infection, and sepsis. Analyses were done using logistic regression.\nInfection within 30\u2009days postpartum was found among 8.5% of the women undergoing induction of labor compared to 6.8% of the women with spontaneous onset of labor. In adjusted logistic regression analyses, the risk of postpartum infection was significantly increased after induction of labor compared to spontaneous onset of labor (adjusted ORs [aOR], 1.24; 95% confidence interval [CI], 1.21-1.27). Women with rupture of membranes were not at increased risk of postpartum infection (aOR 1.01; 95%CI 0.94-1.09). The risk of postpartum maternal sepsis was not significantly associated with induction of labor. Antibiotic treatment during pregnancy, pre-eclampsia, and long education were all associated with increased risk of maternal postpartum infection, while either a low or high body mass index and previous deliveries were associated with decreased risk.\nInduction of labor was associated with an increased risk of maternal postpartum infection. However, the absolute risk was 1.7% higher for the women with induced labor compared to spontaneous onset of labor, which we believe should not be a cause for concern. Unexpectedly, low and high body mass index was associated with decreased risk of infection, and rupture of membranes was not associated with increased risk after induction of labor, which might reflect actual clinical management.",
    "authors": [
        {
            "affiliation": "Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Denmark.",
            "firstname": "Sidsel",
            "initials": "S",
            "lastname": "Hogh-Poulsen"
        },
        {
            "affiliation": "Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Denmark.",
            "firstname": "Sif Emilie",
            "initials": "SE",
            "lastname": "Carlsen"
        },
        {
            "affiliation": "Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Denmark.\nDepartment of Clinical Research, Copenhagen University Hospital-North Zealand, Hillerod, Denmark.",
            "firstname": "Jane M",
            "initials": "JM",
            "lastname": "Bendix"
        },
        {
            "affiliation": "Department of Obstetrics, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.\nDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.",
            "firstname": "Tine D",
            "initials": "TD",
            "lastname": "Clausen"
        },
        {
            "affiliation": "Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Denmark.\nDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.",
            "firstname": "Ellen C L",
            "initials": "ECL",
            "lastname": "Lokkegaard"
        },
        {
            "affiliation": "Department of Gynecology and Obstetrics, Copenhagen University Hospital-North Zealand, Denmark.\nDepartment of Gynecology and Obstetrics, Sygehus Lilleb\u00e6lt Kolding, Denmark.",
            "firstname": "Paul Vignir Bryde",
            "initials": "PVB",
            "lastname": "Axelsson"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).",
    "doi": "10.1111/aogs.15035",
    "journal": "Acta obstetricia et gynecologica Scandinavica",
    "keywords": [
        "birth",
        "birth complications",
        "endometritis",
        "infection",
        "postpartum infection",
        "sepsis",
        "surgical site infection",
        "urinary tract infection"
    ],
    "methods": null,
    "publication_date": "2024-12-31",
    "pubmed_id": "39737539\n30414603\n31398311\n32334543\n26598777\n17511893\n31748223\n30089070\n30786997\n29912013\n28693043\n30817905\n33258514\n33768520\n30070803\n36965695\n37454735\n25272330\n31337807\n31296695\n37020319\n22247826\n34273755",
    "results": "Infection within 30\u2009days postpartum was found among 8.5% of the women undergoing induction of labor compared to 6.8% of the women with spontaneous onset of labor. In adjusted logistic regression analyses, the risk of postpartum infection was significantly increased after induction of labor compared to spontaneous onset of labor (adjusted ORs [aOR], 1.24; 95% confidence interval [CI], 1.21-1.27). Women with rupture of membranes were not at increased risk of postpartum infection (aOR 1.01; 95%CI 0.94-1.09). The risk of postpartum maternal sepsis was not significantly associated with induction of labor. Antibiotic treatment during pregnancy, pre-eclampsia, and long education were all associated with increased risk of maternal postpartum infection, while either a low or high body mass index and previous deliveries were associated with decreased risk.",
    "title": "Maternal postpartum infection risk following induction of labor: A Danish national cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x788504f2da80>"
}