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There was no strong evidence of any difference between groups for measures of neonatal asphyxia; low five minute infant Apgar scores (less than seven) or low arterial cord blood pH (RR 1.51, 95% CI 0.25 to 9.02; 858 infants; two trials, low quality evidence ; and, RR 1.01, 95% CI 0.46 to 2.22; 818 infants; one trial, moderate quality evidence, respectively). Mean birthweight was lower in the induction group, but there was considerable heterogeneity between studies for this outcome (mean difference (MD) 178.03 g, 95% CI 315.26 to 40.81; 1190 infants; four studies; I= 89%). In one study with data for 818 women, third and fourth degree perineal tears were increased in the induction group (RR 3.70, 95% CI 1.04 to 13.17).