AMSTERDAM, Netherlands — Children born using induced labor are more likely to struggle in school, new research reveals. Scientists in the Netherlands say the procedure can have long-term consequences on cognitive development. The findings come from a review of 226,684 children in the Netherlands who underwent academic tests at the age of 12.
“We saw a small yet significant reduction in test scores for children born after induced labor from 37 to 41 weeks, compared to children in whom labor was not induced at that same week, among low-risk pregnancies. And while the impact on the individual child may be small this could lead to a potentially large impact on society, given the increasing number of elective inductions,” says Renee Burger, a researcher in the Department of Obstetrics at Amsterdam UMC, in a media release.
Health officials in the United States advise induction after 41 weeks of pregnancy, saying it makes the birth safer for both mother and child. One in three labors are now induced in the U.S.
Labors are also started artificially if the pregnant woman’s waters break early or if she or her baby has a health problem. Those women who choose not to be induced at 41 weeks can continue with twice-weekly monitoring, although it does not guarantee against poor outcomes.
Fewer induced children were on track for college
The Dutch team analyzed national complication-free pregnancy registrations and school performance data that determines secondary school entrance in the Netherlands. At every gestational age up to and including 41 weeks, participants born after an induced labor scored lower than peers born after a wait-and-see policy.
On average, it resulted in 10 percent fewer children getting advice that sets them on track for going to college. Around half of the children (49.8%) induced after 37 weeks received it compared to 54.4 percent of those who weren’t.
If the pregnancy goes without any problems, it is customary in the Netherlands to discuss with women whether they wish to be induced or wait until 42 weeks. This policy is partly based on 2019 studies from the Netherlands and Sweden. They showed that inducing labor at 41 weeks produces a small reduction in the risk of the baby dying before or shortly after delivery. There was also a small reduction in serious problems in the child after birth.
Another study in the U.S. found elective induction in low-risk women giving birth for the first time at 39 weeks had no negative outcomes. It led to a significantly lower frequency of caesarean deliveries, increasing rates of induced labor across the world.
Induced labor becoming more common in America
In the Netherlands in 2021, 28 percent (47,068) of births were induced. In the U.S., this is around 30 percent, while more than 40 percent of first-time mothers are induced in Australia. Although there are often medical reasons, such as high blood pressure or growth problems, the number of elective procedures is rising in all three countries. This has been mainly driven by a rise in cases that are not medically required. Induction has also been linked with a slightly higher risk of autism.
“The tricky part is that the previous studies all looked at short-term outcomes: infant death and serious problems shortly after birth. None of the studies look at the long-term effects of induction on the child, such as cognitive development,” adds Wessel Ganzevoort, a gynecologist and associate professor in Amsterdam UMC’s Department of Obstetrics.
The researchers emphasize the decision to induce labor is always a balance of risks and consequences for child and mother. Pregnancy complications outweigh a modest adverse effect in the long term, such as school performance. However, in a straightforward pregnancy before 41 weeks, when there are no proven benefits, induction should be used with caution.
The study is published in the journal Acta Obstetricia Et Gynecologica Scandinavica (AOGS).
South West News Service writer Mark Waghorn contributed to this report.
