ACOG Response to ARRIVE Trial

The American College of Obstetricians and Gynecologists (ACOG) has reviewed the limited data currently available from the study released Feb. 1 at the Society for Maternal Fetal Medicine annual meeting titled, “A Randomized Trial of Induction Versus Expectant Management,” which is commonly referred to as the ARRIVE Trial. The study’s findings suggest that induction of labor at 39 weeks of gestation among healthy, nulliparous women reduces the rate of cesarean birth as compared to expectant management among the same population, as well as of rates of preeclampsia and gestational hypertension and rates of respiratory support among newborns. It is important to note that strict protocols for the induction and monitoring process and for labor management were used in this study.

The safe prevention of the primary cesarean delivery is of utmost concern to ACOG. While the study suggests that induction of labor in the 39th week of pregnancy resulted in fewer cesarean deliveries, ACOG does not currently recommend routine induction of labor for low-risk pregnant women at 39 weeks. ACOG will evaluate the full study results in the upcoming peer-reviewed publication of the ARRIVE Trial and will address the findings in relevant clinical guidance.