When to INDuce for OverWeight? (WINDOW)

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18+
SponsorUniversity of Aarhus

About this trial

The rate of overweight and obese women becoming pregnant is increasing. Obesity in pregnancy along with delivery by cesarean section in obese women is associated with several complications as compared to normal weight women. The longer the woman is pregnant, the longer she is at risk. In an otherwise low-risk pregnant woman at term, it is an ongoing clinical dilemma, whether the benefits of elective induction of labor and termination of the pregnancy will outweigh the potential harms from concomitant induction and delivery process. The proposed study is a randomized controlled study of elective induction versus expectant management in obese women. The study will be carried out as a national multicenter study with inclusion of 1900 participants from Danish delivery wards. The null hypothesis is that the caesarean section rate is similar with elective induction of labor at 39 weeks of gestation, compared with expectant management among pregnant women with pre- or early pregnancy BMI≥30.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

None

Disqualifiers

Legal or ethical considerations: maternal age <18 years, language difficulties requiring an interpreter or translator

Multiple pregnancy

Previous caesarean section

Uncertain gestational age, defined as gestational age determined by other measurements than the Crown-Rump length (CRL) Measurement

Trial design

Design model

Parallel

Treatments tested in this trial

  • Elective induction of labor at 39 gestational weeks and 0 to 3 days

    Procedure/Surgery

    Elective induction of labor (eIOL) according to local policies

Treatment groups

1,900 Participants
are divided into 2 treatment groups
Group A: Elective induction of labourExperimental treatment 1 intervention
Group B: Expectant managementNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Caesarean section

number (no.)

Time frame
At delivery

Secondary outcomes

1

Mode of delivery if not by caesarean

* Vaginal delivery - no. * Vaginal assisted delivery - no.

Time frame
At delivery
2

Mode of delivery

* Caesarean section - percent * Vaginal delivery - percent * Vaginal assisted delivery - percent

Time frame
At delivery
3

Vaginal assisted delivery

* Forceps - no. * Ventouse - no.

Time frame
At delivery
4

Indication for caesarean section (more than one indication is possible)

* Labour dystocia - no. * Fetal distress - no. * Maternal request - no. * Suspected macrosomia - no. * Non-cephalic presentation - no. * Extensive vaginal bleeding - no. * Suspected uterine rupture - no. * Maternal or fetal complication/condition (free text) - no. * Other indication for caesarean section (free text) - no.

Time frame
At delivery

Other outcomes

1

Neonatal characteristics 1

* Female sex - no. * Birth weight \> 4500 grams (y/n) - no.

Time frame
At delivery
2

Neonatal characteristics 2

\- Mean birth weight - grams

Time frame
At delivery
3

Maternal experience on birth

Childbirth Experience Questionnaire Scoring range is 1 to 4 where higher ratings reflect more positive experiences

Time frame
4-6 weeks postpartum
4

Maternal postnatal depression

* Major Depression Inventory (MDI) * Edinburgh Postnatal Depression Score Scoring range is 1 to 4 where higher ratings reflect more positive experiences

Time frame
4-6 weeks postpartum

Sponsors and contacts

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University of Aarhus

Lead sponsor

Aarhus University Hospital

Collaborator

Randers Regional Hospital

Collaborator

Herning Hospital

Collaborator

Central Jutland Regional Hospital

Collaborator

Nykøbing Falster County Hospital

Collaborator

Odense University Hospital

Collaborator

Rigshospitalet Juliane Marie Centret

Collaborator

Kolding Sygehus

Collaborator

Herlev Hospital

Collaborator

Hvidovre University Hospital

Collaborator

North Zealand's Hospital

Collaborator

Zealand University Hospital - Roskilde

Collaborator