Time-to-delivery and delivery outcomes comparing three methods of labor induction in 7551 nulliparous women: a population-based cohort study

J Perinatol. 2017 Nov;37(11):1197-1203. doi: 10.1038/jp.2017.122. Epub 2017 Aug 31.


Objective: Determine time-to-delivery and mode-of-delivery in labor induction among women with unripe cervix.

Study design: 7551 nulliparous women with singleton deliveries, ⩾37 weeks, Bishop Score ⩽6, induced with dinoprostone, misoprostol or transcervical single balloon catheter. Linear regression analysis was used to estimate mean time-to-delivery with β-estimates and 95% confidence intervals with adjustments. Multivariable logistic regression analysis was used to calculate odds of cesarean delivery, instrumental vaginal delivery, maternal and neonatal outcomes.

Results: Adjusted mean time-to-delivery was 6.9 and 1.5 h shorter, respectively, when inducing labor with balloon catheter (mean 18.3 h, β -6.9, 95% confidence intervals; -7.6 to -6.3) or misoprostol (mean 23.7 h, β -1.5, 95% confidence intervals; -2.3 to -0.8) compared with dinoprostone (mean 25.2 h). There were no significant differences in adverse maternal or infant outcomes between induction methods.

Conclusions: Balloon catheter is the most effective induction method with respect to time-to-delivery in nulliparous women at term compared with prostaglandin methods.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Catheters*
  • Cervical Ripening
  • Chi-Square Distribution
  • Delivery, Obstetric / statistics & numerical data*
  • Dinoprostone*
  • Female
  • Humans
  • Labor, Induced / methods*
  • Misoprostol*
  • Oxytocics*
  • Pregnancy
  • Prospective Studies
  • Time Factors


  • Oxytocics
  • Misoprostol
  • Dinoprostone