Maternal and fetal characteristics predicting Cesarean risk
Induction of labor is one of the most widely used obstetric interventions. However, one-fifth of labor inductions end with a cesarean section. Researchers aimed to assess maternal and fetal characteristics that influence the likelihood of cesarean section following Induction of labor by indications.

This is a secondary analysis of pooled data from four randomized control trials on Induction of labor. Among a total of 2990 women, 313 women had a cesarean section for failure to progress and 227 for suspected fetal compromise. Regarding the risk of cesarean section for failure to progress, women aged 30-35 were at elevated risk compared with younger women. Nulliparous women had a higher risk than multiparous women. Incremental BMI increased the risk. The higher birthweight percentile, using 20-49.9% as a reference, also carried a higher risk for cesarean section due to failure to progress. For cesarean section due to suspected fetal compromise, incremental maternal age and BMI were associated with increased risk. Compared with multiparous women, nulliparous women had increased risk. The low birthweight percentile (less than 10%) carried a significantly higher risk for cesarean section due to suspected fetal compromise compared to those in the 20-49.9% category. Bishop score did not demonstrate a significant relationship with predicting cesarean section rate as compared to vaginal delivery.

Maternal age, BMI, parity, and birth weight percentile are predictors of cesarean section following the Induction of labor both for failure to progress and suspected fetal compromise, but with different directions and magnitude. These characteristics should be considered in combination with the Bishop score to stratify the risk of cesarean section for different indications.