‘Induce first-time mothers over 35 at due date to save babies’
The lives of hundreds of babies could be saved if first-time mothers aged over 35 were induced at their due date, a new study has found.Currently around 26 babies in 10,000 born to older women will die from stillbirth or within the first seven days of life.
But research by the London School of Hygiene and Tropical Medicine and Cambridge University suggests that could be reduced to just 8 deaths in 10,000, a 66 per cent reduction in mortality if women were induced at 40 weeks.
The Royal College of Obstetricians and Gynaecologists (RCOG) said the study was important because the age of women giving birth was increasing. Around 20 per cent of British babies are now born to women who are 35 or above, accounting for around 140,000 births annually, and 40,000 of those are first-time mothers.
The research was published in the journal PLOS One.The new figures suggest that if the death rate was cut by two thirds, then the number of deaths would fall from more than one hundred to just 32, and could save hundreds of babies as the age of first time mothers increases.
Hannah Knight, lead author from the London School of Hygiene & Tropical Medicine, said: “The number of first-time mothers over the age of 35 is rising. Although their risk of experiencing a stillbirth or neonatal death is relatively small, it’s still very important that these women receive the best advice on how to minimise the risks to themselves and their baby.
“This study represents the strongest evidence yet that moving the offer of induction forward to 40 weeks might reduce the risk of stillbirth in this specific age group, which we know face a greater risk of stillbirth and neonatal death.”
Current guidelines recommend inducing labour at between 41 and 42 weeks – which is one to two weeks after the due date.However the new study suggests that inducing on the due date prevents risks associated with prolonged pregnancy for mother and baby.
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said: “The findings are important because the age at which women are having their first baby is rising with 14 per cent of first time mothers in the UK now aged 35 and over.
“Due to a range of social, professional and financial factors this trend is unlikely to reverse, therefore specific recommendations regarding timing of delivery in older mothers could support future practice in the United Kingdom Kingdom (UK).
“The RCOG welcomes any new research which may help to reduce stillbirth and neonatal death rates, however, as the authors acknowledge, the implications of such a change in policy would be enormous for both the health service and women themselves so further research to determine the impact of such a change in practice is needed.”
Senior author Professor Gordon Smith, Head of the Department of Obstetrics and Gynaecology, University of Cambridge, added: “The study indicates that women aged 35 or over in their first pregnancy should consider induction of labour at their due date.
“Our best estimate is that one stillbirth would be prevented for every 562 inductions of labour. Some women might prefer to avoid induction and to accept this small risk.
“Other women may opt for induction given concerns about the possibility of stillbirth, but a key aspect of the paper is that this analysis provides the best evidence for the magnitude of the risk and allows women to make an informed choice.”
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