Evaluating Ethnic Differences in the Labor Curve in Arabic Women: A Retrospective Cohort Study [8K]

Abstract

INTRODUCTION: Studies have described normal labor curves in nulliparous and multiparous women. Few studies have attempted to analyze data in regards to ethnicity. In this study we present the stages of labor of Arabic women in a community hospital labor and delivery unit. METHODS: We conducted a retrospective cohort study of term, singleton, vertex, laboring Arabic women from 9/2014-7/2016. Exclusion criteria: chorioamnionitis, multiple gestations, induction of labor, non-identifiable ethnicity, previous cesarean desired TOL, chromosomal abnormalities, IUFD and uterine surgery. Cervical dilatation was recorded from admission to delivery. RESULTS: 354 patients were included. 34.5% were nulliparous with mean age 26.1± 4.7 years and neonatal birth weight of 3195.9±367.9 g. 38% had oxytocin. Mean cervical dilatation on admission was 4.2 ± 1.8 cm; the median time from 6-10 cm was 5.5 hours. The median length of second stage was 4.0 hours. 64.6% were multiparous with mean age 29.7 ± 5.1 years and neonatal birth weight of 3344.5 ± 406.3 g. 18.8% had oxytocin. The mean cervical dilatation was 4.7 ± 1.8 cm upon admission, and the median time from 6-10 cm was 3.7 hours. The median length of second stage was 2.1 hours. CONCLUSION: In historical comparison to Friedman's nulliparous, our nulliparous had a longer second stage and took our patient 5.8 h to dilate from 4-10 cm compare to 4 h and 5.3 h in Friedman's and Zheng's nulliparous respectively. Preliminary findings suggest standard management of labor may not apply in this population. Ethnic specific labor progression should be explored further.

Labor patterns in Asian American women with vaginal birth and normal perinatal outcomes

“…Recently, WHO’s BOLD project examined patterns of normal labor in Nigerian and Ugandan women with spontaneous labor onset . The study showed that labor progression in African women in Nigeria and Uganda appeared to be slower than previously reported in other populations, especially at <6 cm of cervix dilation. A diagnostic accuracy study based on this population also showed that the action line of the WHO partograph had a low predictive power for severe adverse birth outcomes; that is, the action line may not be appropriate for diagnosing dystocia.…”

“…There are few studies of labor patterns in Asian women, and findings were often not comparable because of differences in study designs and analytical methods . Therefore, further studies of labor patterns in Asian women are needed.…”