Induction at 38 weeks for large-for-gestational-age or macrosomic fetuses decreases the incidence of cesarean delivery: meta-analysis of randomized controlled trials

Induction of labor between 38 0/7 to 38 4/7 weeks for suspected LGA (EFW >90th percentile) or macrosomic fetuses may be a reasonable management option, as it is associated with significant reductions in cesarean delivery, and a potential reduction in shoulder dystocia, and neonatal fractures, compared to expectant management. As the strongest evidence derives from induction at 38 0/7 to 38 4/7 weeks, counseling should emphasize this gestational window. Approximately 25 inductions of labor for EFW >90th percentile at 38 0/7 to 38 4/7 weeks would be required to prevent 1 cesarean delivery.