干旱区生态环境知识资源中心(Arid): Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study

Arid

DOI	10.1111/aogs.14929
	Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study
	Eide, Birgitte; Sande, Ragnar Kvie; Von Brandis, Phillip; Kessler, Jorg; Tappert, Christian; Eggebo, Torbjorn Moe
通讯作者	Eggebo, TM
来源期刊	ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
ISSN	0001-6349
EISSN	1600-0412
出版年	2024
卷号	103 期号:9 页码:1888-1897
英文摘要	IntroductionIn clinical experience, occiput posterior (OP) position is associated with longer labor duration than occiput anterior (OA) position, but few studies have investigated the association between labor duration and fetal position. We aimed to compare duration of the active phase of labor in OP deliveries with OA deliveries in a contemporary population using survival methods. Secondary aims were to compare the frequencies of operative interventions, obstetric anal sphincter injuries (OASIS), postpartum hemorrhage, and newborn outcomes in OP with OA deliveries.Material and MethodsWe did a historical cohort study in three university hospitals in Norway from 2012 to 2022. Women with a single fetus in cephalic presentation, no previous cesarean section and gestational age >= 37 weeks were eligible and stratified into the first four groups of the Robson ten-group classification system (TGCS). We estimated the mean duration and calculated the hazard ratio (HR) for delivery using survival analyses. Cesarean sections and instrumental vaginal deliveries were censored.ResultsThe study population comprised 112 019 women, 105 571 (94.2%) were delivered in OA and 6448 (5.8%) in OP position. The estimated mean duration of the active phase of labor was longer in women with the fetus in OP position in all four TGCS groups. The estimated duration was longer in the OP groups in analyses stratified with respect to epidural analgesia and oxytocin augmentation. The graphical abstract illustrates the probability of delivery in OP compared with OA position in merged TGCS groups 1 and 2a, as a function of time. The unadjusted HR was 0.33 (95% CI 0.31-0.36) for fetuses delivered in OP position compared with OA position in TGCS group 1, 0.25 (95% CI 0.21-0.27) in group 2a, 0.70 (95% CI 0.67-0.73) in group 3, and 0.61 (95% CI 0.55-0.67) in group 4a, respectively. Neither maternal age, gestational age, BMI nor birthweight had confounding effect. Operative delivery rates and OASIS rates were higher in OP position in all four groups.ConclusionsWe found longer duration of the active phase of labor in women with the fetus delivered in OP position in all four TGCS groups. One-minus survival plots showing the probability for delivery of fetus if in occiput posterior (OP) versus occiput anterior (OA) position during the active phase of labor for Robson ten-group classification system group 1 and 2a (nulliparous women). The red line represents OP deliveries, and the blue line represents OA deliveries.image
英文关键词	Apgar score cesarean section instrumental delivery labor duration occiput posterior position
类型	Article
语种	英语
开放获取类型	hybrid, Green Accepted
收录类别	SCI-E
WOS记录号	WOS:001274992900001
WOS关键词	OCCIPUT POSTERIOR POSITION ; HEAD POSITION ; INTRAPARTUM SONOGRAPHY ; 2ND-STAGE ; CLASSIFICATION ; STAGE
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/402601
推荐引用方式 GB/T 7714	Eide, Birgitte,Sande, Ragnar Kvie,Von Brandis, Phillip,et al. Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study[J],2024,103(9):1888-1897.
APA	Eide, Birgitte,Sande, Ragnar Kvie,Von Brandis, Phillip,Kessler, Jorg,Tappert, Christian,&Eggebo, Torbjorn Moe.(2024).Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study.ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA,103(9),1888-1897.
MLA	Eide, Birgitte,et al."Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study".ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA 103.9(2024):1888-1897.