Inpatient Versus Outpatient Labor Induction: A Systematic Review and Meta-analysis [19F]
Bibliographic record
Abstract
INTRODUCTION: The purpose of this study was to compare clinical and cost outcomes between inpatient and outpatient labor induction. METHODS: A systematic review of randomized controlled trials (RCTs) that compared inpatient vs. outpatient induction was conducted. Four databases were searched for RCTs published in English, which compared any method of outpatient vs. inpatient labor induction. As significant heterogeneity between studies was anticipated, random-effects meta-analysis was conducted. Results were presented as odds ratios (OR) and mean difference (MD) with 95% confidence intervals (95% CI) as appropriate. RESULTS: We identified 695 studies of which 10 representing 7 RCTs (2038 patients) conducted in Australia (n=3), Canada, Portugal, the Netherlands and United States were included in the final analysis. Three RCTs compared induction using balloon catheters, two compared prostaglandins, one compared balloon catheters (outpatient) vs. prostaglandin (inpatient) and one compared outpatient amniotomy vs. inpatient induction using the obstetricians' method of choice. Outpatient vs. inpatient induction was associated with a significant reduction in admission-to-delivery duration [2 studies, 231 patients: MD 11.78 hours (7.09, 16.49)]. There was no difference in use of epidural analgesia [4 studies, 475/863 vs. 454/832, OR 1.04 (0.84, 1.27)], oxytocin [4 studies, 292/643 vs. 269/632, OR 1.143 (0.52, 2.52)], vaginal birth [5 studies, 392/708 vs. 388/697, OR 0.97 (0.70, 1.32)], hyperstimulation [4 studies, 12/643 vs. 9/632, OR 1.27 (0.52, 3.11)] or costs [MD $80.21 (-638.20, 798.61)]. CONCLUSION: Outpatient labor induction is associated with shorter admission-to-delivery duration, with no significant differences in adverse clinical or cost outcomes and may therefore be considered as an alternative to inpatient IOL in low-risk pregnancies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.053 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.027 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".