Self-reported maternal health three months after cervical ripening according to the method: A prospective cohort study among nulliparous women.

INTRODUCTION: Little is known about maternal health after induction of labor according to cervical ripening method. We aimed to compare self-reported health status at 3 months postpartum according to cervical ripening method in nulliparous women. MATERIAL AND METHODS: This prospective cohort study included nulliparous women undergoing cervical ripening using cervical ripening balloon (CRB), dinoprostone vaginal insert (PG), oral misoprostol (M), or repeated methods (R). The primary outcome was self-reported health status at 3 months postpartum, assessed using the EQ-VAS component of the EQ-5D-5L questionnaire. The association between cervical ripening method and EQ-VAS score was assessed using multivariable linear regression adjusted for maternal age, pre-pregnancy BMI, and Bishop score before cervical ripening. RESULTS: Among 362 eligible women, 197 (54.4%) completed the 3-month assessment: 61 CRB, 70 PG, 11 M, and 55 R. Median EQ-VAS score was 90 [IQR 80-97] and did not differ significantly according to cervical ripening method (P=0.63). In multivariable analysis, no statistically significant association was observed between cervical ripening method and EQ-VAS score (overall P=0.60). Compared with CRB, adjusted mean differences were +2.1 points (95% CI -6.9 to 11.0) for M, +2.1 (-2.8 to 6.9) for PG, and -1.3 (-6.5 to 3.9) for R. No significant differences were observed across the five EQ-5D-5L dimensions. CONCLUSION: No statistically significant association was observed between cervical ripening method and self-reported health status at 3 months postpartum. These findings should be interpreted cautiously given the limited sample size and observational design.