Prolonged interpregnancy interval: how does it impact the length of second stage of labor?

2020 ◽  
Vol 48 (8) ◽  
pp. 811-818
Author(s):  
Nicole B. Kurata ◽  
Keith K. Ogasawara ◽  
Kathryn L. Pedula ◽  
William A. Goh
Keyword(s):  
Perinatal Outcomes ◽  
Kaiser Permanente ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Labor Duration ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
Comparison Groups ◽  
Maternal And Neonatal Outcomes ◽  
Interpregnancy Intervals

AbstractObjectivesShort interpregnancy intervals (IPI) have been linked to multiple adverse maternal and neonatal outcomes, but less is known about prolonged IPI, including its relationship with labor progression. The objective of the study was to investigate whether prolonged IPIs are associated with longer second stages of labor.MethodsA perinatal database from Kaiser Permanente Hawaii was used to identify 442 women with a prolonged IPI ≥60 months. Four hundred forty two nulliparous and 442 multiparous women with an IPI 18–59 months were selected as comparison groups. The primary outcome was second stage of labor duration. Perinatal outcomes were compared between these groups.ResultsThe median (IQR) second stage of labor duration was 76 (38–141) min in nulliparous women, 15 (9–28) min in multiparous women, and 18 (10–38) min in women with a prolonged IPI (p<0.0001). Pairwise comparisons revealed significantly different second stage duration in the nulliparous group compared to both the multiparous and prolonged IPI groups, but no difference between the multiparous and prolonged IPI groups. There was a significant association with the length of the IPI; median duration 30 (12–61) min for IPI ≥120 months vs. 15 (9–27) min for IPI 18–59 months and 16 (9–31) min for IPI 60–119 months (p=0.0014).ConclusionsThe second stage of labor did not differ in women with a prolonged IPI compared to normal multiparous women. Women with an IPI ≥120 months had a significantly longer second stage vs. those with a shorter IPI. These findings provide a better understanding of labor progression in pregnancies with a prolonged IPI.

scholarly journals Second-stage labor duration in nulliparous women: relationship to maternal and perinatal outcomes

2009 ◽  
Vol 201 (4) ◽  
pp. 357.e1-357.e7 ◽  
Author(s):  
Dwight J. Rouse ◽  
Steven J. Weiner ◽  
Steven L. Bloom ◽  
Michael W. Varner ◽  
Catherine Y. Spong ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Second Stage ◽  
Labor Duration ◽  
Nulliparous Women ◽  
Second Stage Labor

Influence of Habitual Physical Activity During Late Pregnancy on the Duration of Labor

2017 ◽  
Vol 14 (3) ◽  
pp. 203-207
Author(s):  
Yuki Kondo ◽  
Ryuichi Sawa ◽  
Aoi Ebina ◽  
Masayo Takada ◽  
Hiromi Fujii ◽  
...  
Keyword(s):  
Physical Activity ◽  
Late Pregnancy ◽  
Habitual Physical Activity ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Activity Group ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Birth Records

Background:Physical activity during pregnancy has numerous benefits, but the influence on the duration of labor is unclear. We investigated the influence of habitual physical activity during late pregnancy on the duration of labor, with consideration of previous delivery experience and the stage of labor.Methods:This prospective study included 103 women (48 nulliparous, 55 multiparous) in late pregnancy. Habitual physical activity was evaluated using the Baecke physical activity questionnaire (BQ). Women were divided into a high activity group (HA) and a low activity group (LA) based on their median total BQ score. Data pertaining to the duration of labor were obtained from the birth records after delivery.Results:In multiparous women, the duration of the second stage of labor was significantly shorter in the HA group than in the LA group [median (range): HA, 11 min (1–102 min); LA, 20 min (4–175 min); P < .05]. The significant difference persisted after adjusting for confounding variables (standardized β = –0.34; P = .01). In nulliparous women, there were no significant differences in duration of labor between groups.Conclusions:Higher physical activity in multiparous women during late pregnancy might positively influence the duration of the second stage of labor.

Duration of the second stage of labor in multiparous women: maternal and neonatal outcomes

2007 ◽  
Vol 196 (6) ◽  
pp. 585.e1-585.e6 ◽  
Author(s):  
Yvonne W. Cheng ◽  
Linda M. Hopkins ◽  
Russell K. Laros ◽  
Aaron B. Caughey
Keyword(s):  
Neonatal Outcomes ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Multiparous Women ◽  
Maternal And Neonatal Outcomes

scholarly journals The Impact of Labor Stage Duration on Adverse Maternal and Neonatal Outcomes in Multiparous Women: A Retrospective Cohort Study

2020 ◽  
Author(s):  
li wang ◽  
hongxia Wang ◽  
lu jia ◽  
wenjie qing ◽  
fan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Stage Duration ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Multiparous Women ◽  
Maternal And Neonatal Outcomes ◽  
The Impact

Abstract Background The duration of first and second stages of labor was increased in the consensus that American College of Obstetricians and Gynecologists (ACOG) published 2014. Studies showed increased adverse maternal and neonatal outcomes in nulliparous women with prolonged second stage of labor. It is not very clear that the impact of labor stage duration on multiparous women.Methods A retrospective cohort study was performed. Cephalic, term, singleton multiparous women were included, who planned for vaginal delivery. Adverse maternal outcomes were defined as referral cesarean delivery, instrumental delivery, postpartum hemorrhage, perineal laceration (3rd and 4th degree), hospitalization stay ≥ 90%th, and adverse neonatal outcomes as NICU, shoulder dystocia, Apgar score ≤ 7(5 min), neonatal resuscitation, assisted ventilation required immediately after delivery. We defined the total stage included the first and second stage of labor.Results There were 7109 parturients included, The duration of first stage was 6.2(3.6–10.0) hours in multiparous women, the second stage was 0.3(0.2–0.7) hours, the total stage was 6.9(4.1–10.7) hours. In the first stage, the rate of overall adverse outcomes was 21%, 23.4%, 28.8%, 35.5%, 38.4% in < 6 h, 6-11.9 h, 12-17.9 h, 18-23.9 h, ≥ 24 h, increased significantly (X2 = 57.64, P๤0.001). Compared with < 6 h, ARR(95%CI) were 1.10(0.92,1.31), 1.33(1.04,1.70), 1.80(1.21,2.68), 2.57(1.60,4.15);In the second stage, the rate of overall adverse outcomes increased from 20.0%, 30.7%, 38.5%, to 61.2%, 69.6% in < 1 h, 1-1.9 h, 2-2.9 h, 3-3.9 h, ≥ 4 h (X2 = 349.70, P๤0.001). Compared with < 1 h, ARR (95% CI) were 1.89 (1.50, 2.39), 2.22 (1.55, 3.18), 10.64 (6.09, 18.59), 11.75 (6.55, 21.08); In the total stage, the rate of overall adverse outcomes were 21.5%, 30.8%, 42.4% in < 12 h, 12-23.9 h, ≥ 24 h (X2 = 84.90, P๤0.001). Compared with < 12 h, ARR (95% CI) were 1.41(1.16,1.72), 3.17 (2.10,4.80).Conclusions The prolonged labor stage may lead to increased adverse outcomes in multiparous women, even in the first stage. The duration of labor stage was an independent risk factor for adverse maternal and neonatal outcomes.

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

2020 ◽  
Vol 17 (21) ◽  
pp. 7762
Author(s):  
Nuria Infante-Torres ◽  
Milagros Molina-Alarcón ◽  
Angel Arias-Arias ◽  
Julián Rodríguez-Almagro ◽  
Antonio Hernández-Martínez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Neonatal Outcomes ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Multiparous Women

To evaluate the association between prolonged second stage of labor and the risk of adverse neonatal outcomes with a systematic review and meta-analysis. PubMed, Scopus and EMBASE were searched using the search strategy “Labor Stage, Second” AND (length OR duration OR prolonged OR abnormal OR excessive). Observational studies that examine the relationship between prolonged second stage of labor and neonatal outcomes were selected. Prolonged second stage of labor was defined as 4 h or more in nulliparous women and 3 h or more in multiparous women. The main neonatal outcomes were 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, neonatal sepsis and neonatal death. Data collection and quality assessment were carried out independently by the three reviewers. Twelve studies were selected including 266,479 women. In nulliparous women, a second stage duration greater than 4 h increased the risk of 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit and neonatal sepsis and intubation. In multiparous women, a second stage of labor greater than 3 h was related to 5 min Apgar score <7, admission to the Neonatal Intensive Care Unit, meconium staining and composite neonatal morbidity. Prolonged second stage of labor increased the risk of 5 min Apgar score <7 and admission to the Neonatal Intensive Care Unit in nulliparous and multiparous women, without increasing the risk of neonatal death. This review demonstrates that prolonged second stage of labor increases the risk of neonatal complications in nulliparous and multiparous women.

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