Experts from the Royal College of Obstetricians and Gynaecologists (RCOG) have stated that induction of labour at term in women of advanced maternal age may reduce the risk of stillbirth and neonatal complications.

The findings were published in a new Scientific Impact Paper, Induction of labour at term in older mothers.  The paper looks at a number of epidemiological studies that have identified a link with gestation and maternal age influencing the risk of stillbirth and adverse fetal outcomes.

Data from these studies show the risk of stillbirth at 39-40 weeks gestation is doubled for women aged 40 years or over, and at 39 weeks gestation older women have a similar stillbirth risk to women aged in their late 20s at 41 weeks gestation.

Charlotte Bevan, Sands Research & Prevention Advisor, said: “Sands has argued hard that every year hundreds of stillbirths are potentially avoidable with better, more targeted care and that is exactly what this paper shows: that the offer of induction to older women, which research has long shown are at greater risk of losing their baby, just around the time when they are preparing for birth, could save the lives of dozens of babies every year.”

“It is particularly heart-breaking to hear of a family who have struggled to conceive, for whom this may be a first baby conceived with the help of fertility treatment, who go well beyond term in their pregnancy only to lose the baby in the final days before birth. That family may never go on to have another child.”

We are pleased that the paper also shows that, contrary to popular belief, induction is not linked with an increase in emergency caesarean sections in women of all ages.

Dr Anna Kenyon, University College London Hospital and co-author of the paper, said: “It is justifiable for experts to conclude that inducing labour at an earlier stage of gestation (39-40 weeks) in older mothers (40+ years) could prevent late stillbirth and any maternal risks of an ongoing pregnancy, without increasing the number of operative vaginal deliveries or emergency caesarean sections.”

“Further research is required to more clearly define the effect of induction of labour in women of advanced maternal age.”

The publication of the findings generated a number of posts on our Facebook page of mums reporting that their baby died at term. More than 1,000 babies in the UK are stillborn at term every year, many in so-called low risk pregnancies. Of the 4,000 babies who are stillborn every year in the UK, these represent the most avoidable deaths of all, not least because any intervention (such as induction at term for babies to older mums) is likely to cause the least harm.

Advanced maternal age is strongly associated with an increased risk of stillbirth and neonatal death; the average maternal age in the UK has risen dramatically over the past two decades.  In England the number of babies born each year to women aged 40 or above jumped by 81 per cent between 2001 and 2011.

The Royal College of Obstetricians and Gynaecologists Scientific Impact Paper on induction of labour at term can be downloaded here.

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