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Does Induction with Misoprostol Impact the Small for Gestational Age Neonate? Am J Perinatol 2015 Dec;32(14):1311-7

Date

09/10/2015

Pubmed ID

26352682

DOI

10.1055/s-0035-1563718

Scopus ID

2-s2.0-84988476314 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

OBJECTIVE: To compare outcomes in small for gestational age neonates induced with misoprostol to other cervical ripening agents. We hypothesized that misoprostol use will demonstrate no significant difference in outcomes compared with alternative agents.

STUDY DESIGN: Small for gestational age neonates (<10th percentile for gestational age) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) sponsored Consortium on Safe Labor database were analyzed. Neonates induced with misoprostol ± oxytocin (n = 451) were compared with neonates induced with prostaglandin E2 ± oxytocin and/or mechanical dilation ± oxytocin (n = 663). Primary outcomes included intrapartum fetal distress, cesarean section for fetal distress, cesarean section for any reason, neonatal intensive care unit admission, low 5-minute Apgar, and composite neonatal morbidity. Multiple logistic regression was used to calculate adjusted odds ratios (aORs). Data were analyzed using SAS.

RESULTS: Small for gestational age neonates induced with misoprostol ± oxytocin compared with alternative agents had decreased low 5-minute Apgar scores (aOR 0.27 [0.10-0.71]). No significant differences were demonstrated among very small for gestational age neonates (<5th percentile for gestational age).

CONCLUSION: Our results suggest that misoprostol does not increase risk of adverse outcomes in small for gestational age neonates; however, prospective studies are warranted to further assess optimal cervical ripening agents in this population.

Author List

Foeller ME, Cruz MO, Kominiarek MA, Hibbard JU

Author

Meredith Cruz MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Apgar Score
Cesarean Section
Dilatation
Dinoprostone
Female
Fetal Distress
Humans
Infant, Newborn
Infant, Small for Gestational Age
Intensive Care Units, Neonatal
Labor, Induced
Misoprostol
Oxytocics
Oxytocin
Patient Admission
Pregnancy
Retrospective Studies
Young Adult