TILT: Timing of Induction of Labour at Term.

The trial is open for other centres to join the study.

For women with a singleton pregnancy at term, the risk of perinatal mortality and morbidity increases with advancing gestational age, the lowest risk being at 38-39 weeks. The lowest risk of maternal morbidity is associated with birth at 39 weeks. There have been many recent calls in the literature for randomised controlled trials to evaluate the appropriate time to offer induction of labour for women at term. The randomised controlled trial remains the "gold standard" research methodology for assessing the effects of health care interventions. Such evaluation to date for this research question has been inadequate. Three small randomised controlled trials identified in the literature addressing the optimal time of induction for women with a singleton pregnancy are inadequately powered to detect all but large differences in perinatal mortality, and have not reported other important maternal or infant health outcomes. This randomised controlled trial will assess the benefits and risks of induction of labour at 39 weeks compared with standard care (induction at 41 weeks) for women with a singleton pregnancy at term, to improve maternal and infant health. Induction of labour at 38 weeks gestation may be a safe and effective way to improve maternal and infant health outcomes for women with a singleton pregnancy at term.