Inducing labor at 39 weeks versus later induction or waiting in low‑risk pregnancies in China.

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized trial enrolls low‑risk pregnant women at 38 weeks 4 days to 39 weeks 3 days and randomly assigns them to induction at 39 weeks, induction at 41 weeks, or expectant management. The primary outcome is cesarean delivery rate, with collection of other maternal and neonatal outcomes to compare safety and benefits across groups. Cord blood samples will undergo multi‑omics analyses (including metabolomics and proteomics) to identify biological markers associated with outcomes. The trial is led by the Women's Hospital, School of Medicine, Zhejiang University at its Hangzhou site.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥18 years.
2. Singleton pregnancy or twin pregnancy reduced to singleton before 14 weeks.
3. Gestational age between 38 weeks 4 days or 38 weeks 6 days at randomization.
4. Eligible for vaginal delivery with a desire for vaginal birth.
5. Reliable gestational age determination.
6. Maternal and fetal conditions assessed as low-risk by at least two senior obstetricians, with no indications requiring delivery before 41 weeks.
7. Ability to understand study information and provide informed consent.

Exclusion Criteria:

1. First-trimester ultrasound estimate \>13 weeks 6 days.
2. Planned induction before 41 weeks.
3. Planned cesarean delivery or contraindications to vaginal delivery.
4. Already delivered, in labor, or ruptured membranes at enrollment.
5. Placenta previa, vasa previa, placenta accreta, or placental abruption.
6. Contraindications to induction (e.g., cervical cancer, history of uterine rupture, genital tract malformations, abnormal fetal position, cord prolapse).
7. Active vaginal bleeding exceeding spotting.
8. History of cesarean delivery or uterine/cervical surgery.
9. Cervical cerclage during this pregnancy.
10. Maternal conditions not suitable for expectant management beyond 39 weeks (e.g., pregestational diabetes, gestational diabetes requiring insulin, hypertensive disorders, intrahepatic cholestasis of pregnancy).
11. Fetal conditions not suitable for expectant management beyond 39 weeks (e.g., fetal death, major anomalies, growth restriction, macrosomia, anemia, oligohydramnios, polyhydramnios).
12. Maternal infections or positive screenings for sexually transmitted pathogens or group B Streptococcus.
13. Planned delivery at a non-study facility.
14. Participation in another intervention study affecting delivery management.

Where it's running

• Women's Hospital School of Medicine Zhejiang University
  Hangzhou, Zhejiang, China Recruiting

Study contacts

• Principal investigator: Dan Zhang, Ph. D. — Key Laboratory of Reproductive Genetics, Women's Hospital, Zhejiang University School of Medicine
• Study coordinator: Huajing Gao, MD Candidate
• Email: huajingg@zju.edu.cn
• Phone: 86+18867114750

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.