Does Increase in Birth Weight Change the Normal Labor Curve?

Leftwich, Heidi; Gao, Weihua; Wilkins, Isabelle

doi:10.1055/s-0034-1376180

Cited by 4 publications

(4 citation statements)

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“…In studies of labor 6 decades ago, Friedman found an large increase in the length of active nulliparous labor with increasing birthweight [27], but this association was much weaker among multipara [28]. This association was also found in the work of Nesheim [13] and in a large study which included women who delivered singleton, cephalic babies with gestational age >34 weeks at 19 hospitals in the United States [6]. This recent study analyzed birthweight in 0.5-kg increments and found that birthweight of more than 3 kg apparently became a factor in prolonging labor in multiparous women.…”

Section: Discussionmentioning

confidence: 75%

“…Many studies have examined the total length of the stages or phases of labor, or the median time of dilation in 1-cm integers (traverse time) [4, 6–8]. However, there is little consensus on the definitions of labor onset or the transition from latent to active phase [9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…This gradual transition between the latent and active phases of the first stage of labor makes it difficult or impossible to objectively identify the onset of active labor. Average labor curves and tables showing median traverse time in centimeter integers can help diagnose abnormally slow labor progression but are not designed to estimate time to completion of cervical dilation conditional on the cervical opening and other factors known to be associated with the length of labor, including maternal age [12], height [13], body mass index (BMI) [14], parity [8], gestational age [15], and birthweight [6]. As well, timing of admission to the delivery unit [16], epidural analgesia [15, 17], and oxytocin use [18] are known to be associated with length of labor.…”

Section: Introductionmentioning

confidence: 99%

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On predicting time to completion for the first stage of spontaneous labor at term in multiparous women

Gunnarsson

Skogvoll

Jónsdóttir

et al. 2017

BMC Pregnancy Childbirth

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BackgroundLabor that progresses faster than anticipated may lead to unplanned out-of-hospital births. With the aim to improve planning of transportation to birthing institutions, this study investigated predictors of time to completion for the first stage of labor conditional on cervical opening (conditional time) in multiparous women at term.MethodsWe performed a retrospective analysis of partograms for women in Robson’s group 3 who delivered at one hospital from 2003 to 2013. A generalized additive mixed model was fitted, accounting for possible non-linear relationships between the predictor variables and outcome, e.g. the time from each cervical measurement to full dilation, using multiple measurements for each woman. The following predictors were included: cervical dilation (cm), parity (1, 2, or ≥3 previous vaginal births), oxytocin infusion (no/yes), epidural (no/yes), maternal age (years), maternal height (cm), body mass index (BMI, kg/m2), birthweight (kg), spontaneous rupture of membranes (no/yes). A modified regression model with gestational age (days) instead of birthweight was used to predict conditional time to full cervical dilation for combinations of the most relevant predictors.ResultsA total of 1753 partograms were included in the analysis. The strongest predictors were birthweight, epidural and oxytocin use, and spontaneous rupture of membranes, along with cervical measurements. For birthweight, there was an almost 40% increase in time to full cervical dilation for each 1-kg increment. Conditional time was on average 23% longer in cases with epidural use and 53% longer in cases requiring oxytocin augmentation. Spontaneous rupture of the membranes shortened conditional time by 31%. Maternal age was not associated with the outcome, while increasing BMI and parity modestly reduced conditional time.ConclusionsHigher parity, lower fetal weight (gestational age), and spontaneous rupture of the membranes are associated with more rapid labor.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1345-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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On predicting time to completion for the first stage of spontaneous labor at term in multiparous women

Gunnarsson

Skogvoll

Jónsdóttir

et al. 2017

BMC Pregnancy Childbirth

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“…Leftwich et al [30] have shown that in a large cohort of contemporary laboring women, as birth weight increases, progression in labor is, in fact slower. In the present study, in nulliparous women, there were significant differences in the length of first stage of labor, active phase, the second stage of labor, and total labor duration among the different neonatal birth weight groups.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting labor duration in Chinese pregnant women

Chen

Cao

et al. 2018

Medicine

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The aim of the study was to explore the role of parity, maternal age, medical interventions, and birth weight with respect to labor duration and cervical dilation. A total of 1601 pregnant women who had a singleton term gestation, spontaneous onset of labor, vertex presentation, vaginal delivery, and a normal perinatal outcome were reviewed. The retrospective study was conducted in patients from West China Second University Hospital of Sichuan University during June 2008 to June 2013. There were 1367 nulliparous women and 234 multiparous women analyzed. The first stage (8.3 ± 3.8 vs 5.0 ± 2.6 hours), latent phase (5.1 ± 3.2 vs 3.5 ± 2.4 hours), active phase (3.2 ± 1.8 vs 1.5 ± 1.0 hours), second stage (44 ± 31 vs 18 ± 14 minutes), and total stage of labor (9.1 ± 3.9 vs 5.4 ± 2.6 hours) were all longer in nulliparous than in multipara women (all P < .05); but no significant difference in the third stage of labor (both 7 ± 4 minutes). In nulliparous women, the average time of first stage of labor increased by 58.257, 171.443, and 56.581 minutes due to artificial rupture of membranes, labor analgesia, and birth weight increased by 1 kg, respectively, but it decreased to 63.592 minutes by oxytocin usage, and the difference was significant. The average time of first stage of labor in nulliparous women aged from 26 to 30 years increased by 2.356 minutes compared to one in 20 to 26 years, but it increased by 1.802 minutes to the one in 30 to 39 years, compared to 20 to 26 years and the difference was not significant. The results were basically similar after multipara women were included. Labor was significantly shorter in multiparous women than that in nulliparous women. Increased birth weight significantly increased in the length of the active phase and the second stage among nulliparous women. The increase of age, artificial rupture of membranes, labor analgesia, and the increase of birth weight tends to increase the time of first stage of labor and total labor duration, whereas oxytocin could shorten it.

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Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes

Hung

Chen

et al. 2015

Taiwanese Journal of Obstetrics and Gynecology

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Does Increase in Birth Weight Change the Normal Labor Curve?

Abstract: We have shown that in a large cohort of contemporary laboring women, as birth weight increases, progression in labor is, in fact slower.

Cited by 4 publications

References 10 publications

On predicting time to completion for the first stage of spontaneous labor at term in multiparous women

On predicting time to completion for the first stage of spontaneous labor at term in multiparous women

Factors affecting labor duration in Chinese pregnant women

Contemporary second stage labor patterns in Taiwanese women with normal neonatal outcomes

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