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Evaluating the association between labor induction and cesarean delivery risk depends on the definition of the group to which induction is compared. An investigator used New York State birth-certificate data from 38,000 women with singleton vertex presentations who labored and delivered at term from 2004 to 2008 (48% nulliparous, 52% multiparous; no previous cesarean deliveries) to assess cesarean risk after medical induction compared with spontaneous labor by gestational week or compared with expectant management of all other women either after a given gestational age (all-above comparison group) or at or after that gestational age (at-or-above comparison group).
The induction rate was 30%, and overall cesarean delivery rates were 23% and 4…