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Author summary Why was this study done? Adverse perinatal outcomes are more common among women from deprived areas and ethnic minorities in England. There is debate about whether induction of labour (IOL) with birth at 39 weeks should be offered based on ethnicity or deprivation in low-risk pregnancies, as a means of reducing inequalities. What did the researchers do and find? We analysed a database of all maternity admissions in the English National Health Service (NHS) and measured the association between IOL at 39 weeks and adverse perinatal outcomes in low-risk pregnancies. We found evidence of a small benefit from induction overall in low-risk pregnancies, with 360 inductions associated with the avoidance of 1 adverse perinatal outcome. The benefits of induction were observed mainly in women from more socioeconomically deprived areas and in nulliparous women. What do these findings mean? An increased uptake of IOL with birth at 39 weeks, especially in women from more socioeconomically deprived areas and in nulliparous women, may help reduce inequalities in perinatal outcomes. The greater benefit from IOL with birth at 39 weeks in women from more socioeconomically deprived areas may be explained by an increased prevalence of maternal risk factors. Improved collection of routine data on the indication for induction and the presence of risk factors is required to corroborate the role that IOL at 39 weeks in women with a low-risk pregnancy can play in reducing inequalities in risk of adverse perinatal outcomes.

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