Factors affecting labor duration in Chinese pregnant women

Abstract

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.

Pregnant women’s clinical characteristics, intrapartum interventions, and duration of labour in urban China: a multi-center cross-sectional study

“…Secondly, the results of our study demonstrated that labour duration was significantly longer in nulliparous women than that in multiparous women, which was consistent with Chen et al's finding [39]. Concurrently, durations of the first, second, and total stage of labour in our study was similar to those reported by Chen et al [39].…”

“…Interestingly, however, Vadivelu et al have shown that amniotomy was associated with a shorter labour duration compared with conservative management in women with singleton pregnancies [42]. Conversely, Chen et al found that in nulliparas, the average time of first stage of labour and total labour duration increased due to amniotomy [39]. The association between amniotomy and labour duration varied due to different research designs and inter-study heterogeneity.…”

“…The association between amniotomy and labour duration varied due to different research designs and inter-study heterogeneity. Yet Chen et al's study illustrated that women with medical interventions were more likely to have prolonged labour processes [39]. And there is no evidence that these interventions can improve childbirth experience for women who have had a prolonged labour [43].…”

Perspective on the low labor analgesia rate and practical solutions for improvement in China

“…[ 8 ] For most parturients, experiencing pain during delivery is an important reason why they choose cesarean section; conversely, for obstetricians and midwives, standards and treatment during the labor process are other important reasons for choosing cesarean section. [ 9 – 11 ] The obstetric group of the Chinese Society of Anesthesiology has performed a series of surveys on labor analgesia across the country, polling 42 maternity hospitals (divided into seven groups according to their geographical locations), which included 1,489,228 delivery cases in 3 years. [ 12 ] The labor analgesia rates were listed as follows: 11.65% in northeast China, 29.97% in northern China, 30.77% in east China, 17.97% in north China, 11.65% in southern China, 19.66% in central China, 1.02% in northwest China, and 7.56% in southwest China (unpublished).…”

Analysis of the Impact of Cervical Excision Procedure on Delivery Mode

“…Secondly, cervix has the ability to adjust the position of fetal head, and an incomplete cervix can in uence position of fetal head which is more likely to lead a cephalic presentation dystocia. In addition, women with a prior cervical excision procedure were elder in our study, who might undergo a physiologic aging process of myometrial tissues and skeletal muscle [17]. Those three reasons may prolong the duration of the second stage of labor.…”