Background and Rationale

Current guidelines generally recommend induction of labor at 41 weeks of gestation, but the U.S. ARRIVE trial demonstrated that induction at 39 weeks reduces the cesarean delivery rate. These findings are limited to Western populations, leaving a gap in data that reflect China’s unique demographics and healthcare setting. Consequently, evidence specific to low‑risk pregnant women in China is needed.

Study Design and Comparator Arms

This study will randomize participants into three arms—induction at 39 weeks, induction at 41 weeks, and expectant management—and compare cesarean rates as well as maternal and neonatal outcomes. Multi‑omics technologies will be employed to profile metabolites and proteins in cord blood. By generating both clinical outcomes and biomarker data concurrently, the trial will furnish empirical evidence to inform policy decisions.

Multi‑Omics and Long‑Term Health Biomarkers

Multi‑omics analysis plays a pivotal role in discovering early biomarkers that can predict long‑term health trajectories of newborns. Metabolomic and proteomic data can be leveraged to identify risks for growth disorders and metabolic diseases at an early stage. These scientific insights have the potential to drive novel diagnostic and preventive strategies not only in obstetrics but also in pediatric and adolescent care.

Pilot Phase and Future Expansion Potential

The investigation will commence as a pilot to assess feasibility and to develop operational strategies for broader clinical implementation. If the pilot succeeds, a nationwide clinical network can be established to offer individualized timing of delivery for all low‑risk pregnant women across China. This approach is expected to improve healthcare resource efficiency and reduce costs associated with cesarean deliveries.