included these
two RCTs as well as nine observational studies including 3751
subjects in total. Observational and RCTs were analysed separately.
Despite these methodological differences, the Irion
and Sanchez-Ramos analyses agreed in their main result, finding
no difference in caesarean deliveries or shoulder dystocia.
Sanchez-Ramos’ analysis of non-randomised studies suggested
that the risk for caesarean delivery may be increased
when induction of labour is undertaken for presumed macrosomia
(149 of 898 [16.6%] versus 214 of 2540 [8.4%], NNH =
12), a finding not confirmed in the small RCTs.19 Larger
randomised studies are underway to further elucidate this
question.