Association of labor induction or stimulation with infant mortality in women with failed versus successful trial of labor after prior cesarean

J Matern Fetal Neonatal Med. 2013 Aug;26(12):1162-5. doi: 10.3109/14767058.2013.777700. Epub 2013 Mar 21.


Objective: To compare infant mortality rates among women with a failed versus successful trial of labor after cesarean (TOLAC) following labor induction or stimulation.

Study design: Using US linked birth and infant death cohort data (2000-2004), we identified women who delivered non-anomalous singleton births at 34-41 weeks with TOLAC whose labors were induced or stimulated. Multivariable log-binomial regression models were fitted to estimate the association between TOLAC success and infant mortality.

Results: Of the 164,113 women who underwent TOLAC, 41% were unsuccessful. After adjustment for potential confounding factors, a failed TOLAC was associated with a 1.4 fold (95% confidence interval [CI] 1.1, 1.7) increased risk of infant mortality.

Conclusions: Among women undergoing labor induction or stimulation, a failed TOLAC is associated with higher likelihood of infant mortality.

MeSH terms

  • Adolescent
  • Adult
  • Cesarean Section*
  • Cohort Studies
  • Female
  • Humans
  • Infant Mortality*
  • Infant, Newborn
  • Labor, Induced / adverse effects*
  • Likelihood Functions
  • Pregnancy
  • Treatment Failure
  • Trial of Labor
  • United States / epidemiology
  • Young Adult