Length of first stage labor and perinatal outcomes

January 01, 0001

Length of first stage labor and perinatal outcomes

These US authors conducted a retrospective cohort study of nulliparous women with term, singleton gestations to estimate whether length of the first stage of labor is associated with adverse maternal and neonatal outcomes. The cohort was from one academic center between 1990 and 2008. The length of the first stage was stratified into three subgroups: less than the 5th percentile, 5th to 95th percentile, and greater than the 95th percentile.

They found: "Of the 10,661 nulliparous women meeting study criteria, the median (50th percentile) length of the first stage was 10.5 hours. Compared with women with a first stage between 2.8 and 30 hours (5th to 95th percentile thresholds), the risk of cesarean delivery was higher (6.1% compared with 13.5%; adjusted OR, 2.28) in women with a first stage longer than 30 hours (greater than the 95th percentile). These women also had higher odds of chorioamnionitis (12.5% compared with 23.5) and neonatal admission to the neonatal intensive care unit (4.7% compared with 9.8%; adjusted OR, 1.53) but no other associated adverse neonatal outcomes."

The authors concluded: "Women with a prolonged first stage of labor have higher odds of cesarean delivery and chorioamnionitis, but their neonates are not at risk of increased morbidity."

Long first stage labor does not by itself imply fetal risk.


For the full abstract, click here.

Obstet Gynecol 116(5):1127-1135, November 2010 © 2010 The American College of Obstetricians and Gynecologists
Length of the First Stage of Labor and Associated Perinatal Outcomes in Nulliparous Women. Yvonne W. Cheng, Brian L. Shaffer, Allison S. Bryant, Aaron B. Caughey. Correspondence to Dr. Cheng: [email protected]

Category: W. Pregnancy, Childbirth, Family Planning. Keywords: first stage labor, duration of labor, chorioamnionitis, neonatal intentis care, retrospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 7 December 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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