SynthesisBMC pregnancy and childbirth2026
Elective induction versus expectant management for suspected large-for-gestational-age fetuses: a systematic review and meta-analysis.
Synthesis in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSuspected large-for-gestational-age (LGA) fetuses present a clinical dilemma: early induction may reduce birth trauma but raise intervention risks. Previous reviews lacked recent data.
objectivesTo assess whether elective induction at 37–39 weeks reduces adverse maternal and neonatal outcomes compared with expectant management in pregnancies with suspected LGA fetuses.
methodsWe systematically searched PubMed, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov through May 2025, with no language restrictions. We included randomised controlled trials (RCTs) comparing elective induction (37–39 weeks) with expectant management in singleton pregnancies with suspected (LGA) fetuses. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using RoB 2.0. Outcomes were pooled using fixed- or random-effects meta-analysis, and the certainty of evidence was evaluated using the GRADE framework. MAIN
resultsThree RCTs (n = 3,984) met the inclusion criteria. Induction significantly reduced shoulder dystocia (RR 0.65, 95% CI 0.46–0.91), caesarean birth (RR 0.87, 95% CI 0.79–0.95), and increased spontaneous vaginal birth (RR 1.12, 95% CI 1.06–1.19). No differences were seen in instrumental delivery, severe perineal trauma, or perinatal death. Induction lowered mean birthweight (–177 g, 95% CI − 279 to − 76) but was associated with increased neonatal phototherapy (RR 1.63, 95% CI 1.19–2.23). Certainty of evidence was moderate for most primary outcomes.
conclusionsFor suspected LGA fetuses, induction around 38 weeks reduces birth trauma and caesarean risk without increasing major maternal or neonatal morbidity. Clinical discussions should weigh these benefits against patient preferences and contextual factors.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.