Relationship Between Prolonged Second Stage of Labor and Short-Term Neonatal Morbidity: A Systematic Review and Meta-Analysis

Infante-Torres, Nuria; Molina‐Alarcón, Milagros; Arias-Arias, Angel; Rodríguez‐Almagro, Julián; Hernández‐Martínez, Antonio

doi:10.3390/ijerph17217762

Cited by 13 publications

(16 citation statements)

References 31 publications

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“…Traditionally labour duration is divided into first and second stage. Several efforts have been made to understand how these two stages of labour influence birth outcomes 1,4,6,24,25 . Labour is a continuous process, which needs be taken into consideration since duration spent at each stage jointly shape labour management decisions and subsequent maternal and neonatal birth outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Several efforts have been made to understand how these two stages of labour influence birth outcomes. 1,4,6,24,25 Labour is a continuous process, which needs be taken into consideration since duration spent at each stage jointly shape labour management decisions and subsequent maternal and neonatal birth outcomes. As we applied a non-parametrical modelling approach on the continuous duration of active first stage, we found a linear increase in second-stage duration up until active first-stage duration of 12 h. This was further shown in the detailed curves for the 80 th and 90 th quantiles (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

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Association between first and second stage of labour duration and mode of delivery: A population‐based cohort study

Lundborg

Åberg

Sandström

et al. 2021

Paediatric Perinatal Epid

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Background: Active first stage of labour duration can widely vary between women.However, the nature of the relationship between the active first stage and second stage of labour duration is sparsely studied. Objectives:To determine whether active first stage of labour duration (i) influences second stage of labour duration; and (ii) is associated with mode of delivery. Methods: A population-based cohort study of 13,379 women primiparous women, with spontaneous start in Stockholm-Gotland Region, Sweden, between 2008 and 2014. Duration of the active first stage of labour was examined in relation to secondstage duration using univariate and multivariable quantile regressions, with the first quartile (first stage duration) as the reference. Nonlinearity of associations was tested by restricted cubic splines. Association between active first-stage duration with mode of delivery was estimated using a multinomial logistic regression based on adjusted odds ratios. Results: Longer active first stage of labour duration was linearly associated with longer second stage of labour duration until approximately 12 h of active first stage of labour duration. After 12 h, a non-linear trend is seen, demonstrated by a plateau in the second-stage duration. In addition, longer active first stage of labour duration was associated with increased occurrence of operative vaginal delivery (adjusted odds ratio 3.36, 95% confidence interval [CI] 2.89, 3.89) and caesarean delivery (adjusted odds ratio 4.75, 95% CI 3.85, 5.80).Conclusions: Among primiparous women with spontaneous onset of labour, longer active first stage of labour duration was associated with both longer second stage of labour duration and higher odds of operative delivery. This study contributes with findings, which may inform future discussions regarding how to properly account for second-stage duration, with applications in obstetric and perinatal epidemiology. K E Y W O R D Sactive first stage of labour, caesarean delivery, epidemiology, labour duration, labour stages, mode of delivery, obstetric, operative delivery, perinatal, second stage of labourThis is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmercia-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association between first and second stage of labour duration and mode of delivery: A population‐based cohort study

Lundborg

Åberg

Sandström

et al. 2021

Paediatric Perinatal Epid

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“…Low neonatal Apgar scores and foetal acidosis are reportedly associated with several perinatal factors 7 , 8 , and the labour environment around the foetus is closely associated with the incidence of low neonatal Apgar scores and foetal acidosis. Prolonged labour duration (LD) affects the incidence of neonatal morbidity 9 , 10 and results in low Apgar scores 10 . However, several studies have indicated that a prolonged first stage of labour is not associated with an increased incidence of adverse neonatal outcomes 11 , 12 and that a prolonged second stage of labour is not associated with an increased incidence of low neonatal Apgar scores and foetal acidosis 13 – 15 .…”

Section: Introductionmentioning

confidence: 99%

Association of labour duration in spontaneous deliveries with low neonatal Apgar scores and foetal acidosis: the Japan Environment and Children’s Study

Murata

Yasuda²,

Imaizumi³

et al. 2022

Sci Rep

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This study evaluated the association between labour duration (LD) and incidence of low neonatal Apgar scores and foetal acidosis. Data of 37,682 women with full-term singleton spontaneous vaginal deliveries from the Japan Environment and Children’s Study were analysed. Women were classified according to the median LD as nulliparous (< 10 or ≥ 10 h) or multiparous (< 5 or ≥ 5 h) and further into five subcategories: nulliparous (< 10.0, 10.0–12.9, 13.0–15.9, 16.0–18.9, and ≥ 19 h) and multiparous (< 5.0, 5.0–7.9, 8.0–10.9, 11.0–13.9, and ≥ 14.0 h). Multiple logistic regression models were used to determine odds ratios (ORs) for outcomes in women with over-median LD. Over-median LD exhibited no statistically significant association with low neonatal Apgar scores. The adjusted ORs for both umbilical artery (UmA-pH) < 7.2 and < 7.1 were increased in nulliparous women with over-median LD, whereas only the adjusted OR for UmA-pH < 7.2 was increased in multiparous women with over-median LD. Moreover, this association manifested as a plateau in nulliparous women with LD ≥ 13 h and without dose-dependent association in multiparous women.

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“…The spontaneous pushing reflex of the pregnant woman comes after the full dilation of the cervix (2)(3)(4)(5). In literature, it is stated that starting to push before the urge to push and encouraging the woman to push can lead to constant exhausting pushings, which may result in maternal fatigue and exhaustion, and therefore the risk of cesarean delivery may increase (3,6). Cesarean delivery may decrease maternal and infant mortality, and complications such as obstetric fistula.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Delayed Pushing During the Second Stage of Labor on Postpartum Fatigue and Labor Results

Bozkurt¹,

Kavlak²,

Özkan

et al. 2021

Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi

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Amaç: Araştırma, doğumun ikinci evresinde ertelenmiş ıkınmanın postpartum yorgunluk ve doğum sonuçlarına etkisini incelemek amacıyla yapılmıştır. Yöntem: Randomize kontrollü deneysel olarak gerçekleştirilen araştırmanın örneklemini 48 primipar gebe (ertelenmiş ıkınma grubu n:23, kontrol grubu n:25) oluşturmuştur. Kontrol grubunda ıkınma, güçlü uterus kontraksiyonları oluştuğunda, fetal baş rotasyonunu tamamladığında başlamıştır. Ertelenmiş ıkınma grubunda kontrol grubundan farklı olarak, fetal baş pelvis içinde "+1" düzeyinde olduğunda ve kadında ıkınma isteğinin olması dikkate alınarak, güçlü ve istemsiz fiziksel itme refleksi hissedene kadar ıkınmanın ertelenmesi istenmiştir. Veri toplamada, "Gebe Tanılama Formu", "İzlem Formu", "Partograf" ve "Yorgunluk İçin Görsel Benzerlik Skalası" kullanılmıştır. Bulgular: İkinci evrenin süre ortalaması ertelenmiş ıkınma grubunda 38.34±17.84 dk, kontrol grubunda 13.52±5.29 dakikadır. Ertelenmiş ıkınma ve kontrol grubu kadınların; doğumun ikinci evresinin süre ortalamaları, ıkınma süre ortalamaları, doğum sonrası ilk bir saatteki yorgunluk ve enerji puan ortalamaları arasında istatistiksel olarak anlamlı fark saptanmıştır (p<0.05). Sonuç: Ertelenmiş ıkınmanın doğumun ikinci evresinin süresini uzattığı, ıkınma süresini azalttığı ve doğum sonrası ilk bir saatteki yorgunluğu anlamlı olarak azalttığı bulunmuştur.

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Relationship Between Prolonged Second Stage of Labor and Short-Term Neonatal Morbidity: A Systematic Review and Meta-Analysis

Cited by 13 publications

References 31 publications

Association between first and second stage of labour duration and mode of delivery: A population‐based cohort study

Association between first and second stage of labour duration and mode of delivery: A population‐based cohort study

Association of labour duration in spontaneous deliveries with low neonatal Apgar scores and foetal acidosis: the Japan Environment and Children’s Study

The Effects of Delayed Pushing During the Second Stage of Labor on Postpartum Fatigue and Labor Results

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