BACKGROUND:
Shared and informed decision making is limited by the lack of available data to inform multiparous women about their odds of various methods of birth and infants’ needs for additional care following induced labour or expectant management.

OBJECTIVES:
To report caesarean births and neonatal nursery admissions following induction compared with expectant management in multiparous women and childbearing persons.

METHODS:
Retrospective cohort study of births in Victoria, Australia, 2018-2022, in women with one or more previous births (no previous cesarean), singleton pregnancy, cephalic presentation at or beyond 37 weeks’ gestation, and not planning a cesarean birth. Multiple regression considered the adjusted odds of caesarean birth and of the infant being admitted to the Special/Intensive Care Nursery following induced labour compared with expectant management, by gestational week.

RESULTS:
There were 134,046 births meeting inclusion criteria: of these, 43.1% were induced, while 56.9% were expectantly managed. Overall, there was a small increase in the adjusted odds of having a caesarean birth following induction (8.1%) or expectant management (7.6%), adjOR 1.05, 95%CI 1.01 – 1.10. This increase was only noted at Week 40 (adjOR 1.4. 95%CI 1.27 – 1.63) and from 41 weeks onwards (adjOR 1.6, 95%CI 1.42 – 1.81). The odds of overall admissions to the Special/Neonatal Intensive Care unit were increased following induction (10.5%) compared with expectant management (7.1%) (adj OR 1.4, 95%CI 1.40 – 1.47. The increase was most prominent in week 37 (adjOR 2.9, 95%CI 2.73 – 3.13), with equivalent odds from 41weeks onwards (adjOR 1.0, 95%CI 0.84 – 1.14).

CONCLUSIONS:
Timing of induction impacts on caesarean births and nursery admissions.

KEY MESSAGE:
Understanding risks and benefits of timing induction versus expectant management for the optimal outcomes can be better considered when such data are available and used for shared decision making. Poster session 1 (Group A)