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On predicting time to completion for the first stage of spontaneous labor at term in multiparous women

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dc.contributor.author Gunnarsson, Björn
dc.contributor.author Skogvoll, Eirik
dc.contributor.author Jónsdóttir, Ingibjörg Hanna
dc.contributor.author Røislien, Jo
dc.contributor.author Smárason, Alexander Kristinn
dc.date.accessioned 2022-03-31T01:01:32Z
dc.date.available 2022-03-31T01:01:32Z
dc.date.issued 2017-06-12
dc.identifier.citation Gunnarsson , B , Skogvoll , E , Jónsdóttir , I H , Røislien , J & Smárason , A K 2017 , ' On predicting time to completion for the first stage of spontaneous labor at term in multiparous women ' , BMC Pregnancy and Childbirth , vol. 17 , no. 1 , 183 . https://doi.org/10.1186/s12884-017-1345-1
dc.identifier.issn 1471-2393
dc.identifier.other PURE: 29913013
dc.identifier.other PURE UUID: 6080c928-b641-4561-b6b9-2cf5c50d62bb
dc.identifier.other Scopus: 85020445008
dc.identifier.uri https://hdl.handle.net/20.500.11815/3000
dc.description Publisher Copyright: © 2017 The Author(s).
dc.description.abstract Background Labor that progresses faster than anticipated may lead to unplanned out-of-hospital births. With the aim to improve planning of transportation to birthing institutions, this study investigated predictors of time to completion for the first stage of labor conditional on cervical opening (conditional time) in multiparous women at term. Methods We performed a retrospective analysis of partograms for women in Robson’s group 3 who delivered at one hospital from 2003 to 2013. A generalized additive mixed model was fitted, accounting for possible non-linear relationships between the predictor variables and outcome, e.g. the time from each cervical measurement to full dilation, using multiple measurements for each woman. The following predictors were included: cervical dilation (cm), parity (1, 2, or ≥3 previous vaginal births), oxytocin infusion (no/yes), epidural (no/yes), maternal age (years), maternal height (cm), body mass index (BMI, kg/m2), birthweight (kg), spontaneous rupture of membranes (no/yes). A modified regression model with gestational age (days) instead of birthweight was used to predict conditional time to full cervical dilation for combinations of the most relevant predictors. Results A total of 1753 partograms were included in the analysis. The strongest predictors were birthweight, epidural and oxytocin use, and spontaneous rupture of membranes, along with cervical measurements. For birthweight, there was an almost 40% increase in time to full cervical dilation for each 1-kg increment. Conditional time was on average 23% longer in cases with epidural use and 53% longer in cases requiring oxytocin augmentation. Spontaneous rupture of the membranes shortened conditional time by 31%. Maternal age was not associated with the outcome, while increasing BMI and parity modestly reduced conditional time. Conclusions Higher parity, lower fetal weight (gestational age), and spontaneous rupture of the membranes are associated with more rapid labor.
dc.description.abstract Background: Labor that progresses faster than anticipated may lead to unplanned out-of-hospital births. With the aim to improve planning of transportation to birthing institutions, this study investigated predictors of time to completion for the first stage of labor conditional on cervical opening (conditional time) in multiparous women at term. Methods: We performed a retrospective analysis of partograms for women in Robson's group 3 who delivered at one hospital from 2003 to 2013. A generalized additive mixed model was fitted, accounting for possible non-linear relationships between the predictor variables and outcome, e.g. the time from each cervical measurement to full dilation, using multiple measurements for each woman. The following predictors were included: cervical dilation (cm), parity (1, 2, or ≥3 previous vaginal births), oxytocin infusion (no/yes), epidural (no/yes), maternal age (years), maternal height (cm), body mass index (BMI, kg/m2), birthweight (kg), spontaneous rupture of membranes (no/yes). A modified regression model with gestational age (days) instead of birthweight was used to predict conditional time to full cervical dilation for combinations of the most relevant predictors. Results: A total of 1753 partograms were included in the analysis. The strongest predictors were birthweight, epidural and oxytocin use, and spontaneous rupture of membranes, along with cervical measurements. For birthweight, there was an almost 40% increase in time to full cervical dilation for each 1-kg increment. Conditional time was on average 23% longer in cases with epidural use and 53% longer in cases requiring oxytocin augmentation. Spontaneous rupture of the membranes shortened conditional time by 31%. Maternal age was not associated with the outcome, while increasing BMI and parity modestly reduced conditional time. Conclusions: Higher parity, lower fetal weight (gestational age), and spontaneous rupture of the membranes are associated with more rapid labor.
dc.format.extent 8
dc.format.extent
dc.language.iso en
dc.relation.ispartofseries BMC Pregnancy and Childbirth; 17(1)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Fæðing
dc.subject Meðganga
dc.subject Barneignir
dc.subject Heilsufar
dc.subject Active labor
dc.subject Birthweight
dc.subject Body mass index
dc.subject Labor progression
dc.subject Partogram
dc.subject Robson's classification
dc.subject Rupture of the membranes
dc.subject Spontaneous labor
dc.subject Obstetrics and Gynecology
dc.title On predicting time to completion for the first stage of spontaneous labor at term in multiparous women
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 28606063
dc.identifier.doi https://doi.org/10.1186/s12884-017-1345-1
dc.relation.url http://www.scopus.com/inward/record.url?scp=85020445008&partnerID=8YFLogxK
dc.contributor.department Faculty of Earth Sciences
dc.contributor.school School of Health Sciences


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