Changes in labor patterns over 50 years - 26/04/12
Résumé |
Objective |
The objective of the study was to examine differences in labor patterns in a modern cohort compared with the 1960s in the United States.
Study Design |
Data from pregnancies at term, in spontaneous labor, with cephalic, singleton fetuses were compared between the Collaborative Perinatal Project (CPP, n = 39,491 delivering 1959-1966) and the Consortium on Safe Labor (CSL; n = 98,359 delivering 2002-2008).
Results |
Compared with the CPP, women in the CSL were older (26.8 ± 6.0 vs 24.1 ± 6.0 years), heavier (body mass index 29.9 ± 5.0 vs 26.3 ± 4.1 kg/m2), had higher epidural (55% vs 4%) and oxytocin use (31% vs 12%), and cesarean delivery (12% vs 3%). First stage of labor in the CSL was longer by a median of 2.6 hours in nulliparas and 2.0 hours in multiparas, even after adjusting for maternal and pregnancy characteristics, suggesting that the prolonged labor is mostly due to changes in practice patterns.
Conclusion |
Labor is longer in the modern obstetrical cohort. The benefit of extensive interventions needs further evaluation.
Le texte complet de cet article est disponible en PDF.Key words : labor, labor curve, labor duration
Plan
| The data included in this paper were partly obtained from the Consortium on Safe Labor, supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract number HHSN267200603425C). The other institutions in the Consortium on Safe Labor are listed with the Acknowledgments section. |
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| The authors report no conflict of interest. |
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| The named authors alone are responsible for the views expressed in this article, which do not necessarily represent the decisions or stated policy of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. |
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| Reprints not available from the authors. |
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| Cite this article as: Laughon SK, Branch DW, Beaver J, et al. Changes in labor patterns over 50 years. Am J Obstet Gynecol 2012;206:419.e1-9. |
Vol 206 - N° 5
P. 419.e1-419.e9 - mai 2012 Retour au numéro
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