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Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population‐based cohort study.
- Source :
- BJOG: An International Journal of Obstetrics & Gynaecology; May2024, Vol. 131 Issue 6, p832-842, 11p
- Publication Year :
- 2024
-
Abstract
- Objective: The impact of first stage labour duration on maternal outcomes is sparsely investigated. We aimed to study the association between a longer active first stage and maternal complications in the early postpartum period. Design: A population‐based cohort study. Setting: Regions of Stockholm and Gotland, Sweden, 2008–2020. Population: A cohort of 159 459 term, singleton, vertex pregnancies, stratified by parity groups. Methods: The exposure was active first stage duration, categorised in percentiles. Poisson regression analysis was performed to estimate the adjusted relative risk (aRR) and the 95% confidence interval (95% CI). To investigate the effect of second stage duration on the outcome, mediation analysis was performed. Main outcome measures: Severe perineal lacerations (third or fourth degree), postpartum infection, urinary retention and haematoma in the birth canal or ruptured sutures. Results: The risks of severe perineal laceration, postpartum infection and urinary retention increased with a longer active first stage, both overall and stratified by parity group. The aRR increased with a longer active first stage, using duration of <50th percentile as the reference. In the ≥90th percentile category, the aRR for postpartum infection was 1.64 (95% CI 1.46–1.84) in primiparous women, 2.43 (95% CI 1.98–2.98) in parous women with no previous caesarean delivery (CD) and 2.33 (95% CI 1.65–3.28) in parous women with a previous CD. The proportion mediated by second stage duration was 33.4% to 36.9% for the different outcomes in primiparous women. The risk of haematoma or ruptured sutures did not increased with a longer active first stage. Conclusions: Increasing active first stage duration is associated with maternal complications in the early postpartum period. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14700328
- Volume :
- 131
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 176352562
- Full Text :
- https://doi.org/10.1111/1471-0528.17692