The Effect of Parity on Efficacy and Safety Outcomes in Induction of Labor [31B]

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We investigated the effect of parity on induction of labor (IOL) outcomes in women treated with either misoprostol (MVI) or dinoprostone vaginal inserts (DVI).


Pooled IOL outcome data were analyzed from 3 phase II/III trials using DVI 10mg and MVI 200µg in nulliparous (DVI n=715/MVI n=522) versus parous (DVI n=390/MVI n=283) women during first hospitalization. Descriptive statistics compared demographics; logistic regression assessed the relationship between parity, treatment, and outcomes. Adverse events (AEs) investigated: 1) abnormal fetal heart rate (FHR II/III), 2) uterine tachysystole (UT), 3) abnormal FHR with/without UT (FHR/UT), 4) abnormal labor affecting the fetus (UT with FHR II/III), 5) UT or hypertonus with/without FHR II/III (UH), 6) meconium, and 7) arrested labor (AL).


Demographics were similar between groups except parous women were older. Parity was associated with a higher odds of vaginal delivery (VD) and lower odds of Cesarean delivery (CD) compared to nulliparity (P<.001). Parous women had fewer specific AEs (FHR II/III, FHR/UT, UH, meconium, AL; P<.001). No differences in odds of VD or CD were observed between treatments. Women in both parity groups had a greater risk of UH (P<.001) if treated with MVI vs DVI, but only nullipara showed greater odds of UT with FHR II/III, FHR/UT, and meconium if treated with MVI vs. DVI (P<.05). There was no statistical evidence of an interaction between parity and treatment.


Parity had improved efficacy and safety outcomes compared to nulliparity. Treatment with MVI led to greater risk of certain AEs; these were more frequently noted in nullipara.

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