Which Pregnant Women Enroll in Clinical Trials — and Why

Enrollment of diverse populations into clinical trials is critical to ensure generalizability of outcomes and to avoid bias. Investigators examined the rates and reasons for declining to enroll in a trial that compared induction at 39 weeks with expectant management in low-risk, nulliparous women.

In all, 28% of eligible women consented to enroll in this multicenter, NIH-sponsored trial. Women who were Black (versus white; odds ratio, 1.5), without private insurance (OR, 1.6), and younger than 29 years were more likely to consent. Asian women were less likely to consent, often citing a preference for expectant management, unwillingness to participate in research, and objections from friends and family, as their reasons.