Prolonged second stage of labor is associated with low Apgar score

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Altman, MariaKarolinska Institutet (author)

Prolonged second stage of labor is associated with low Apgar score

Article/chapterEnglish2015

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2015-05-26
Stockholm :Karolinska Institutet, Dept of Medicine, Solna,2015
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LIBRIS-ID:oai:openarchive.ki.se:10616/44918
ISSN:0393-2990
10616/44918hdl
http://hdl.handle.net/10616/44918URI
https://doi.org/10.1007/s10654-015-0043-4DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:132642495URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 minutes. All nulliparous women (n= 32 796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 minutes <7 and <4. We found that the overall rates of 5 minute Apgar score <7 and <4 were 7.0 and 1.3 per 1000 births, respectively. Compared to women with <1 hour from retracted cervix to birth, adjusted ORs of Apgar score <7 at 5 minutes generally increased with length of second stage of labor: 1-<2 hours: OR 1.78 (95% CI 1.19-2.66); 2- <3 hours: OR 1.66 (1.05-2.62); 3-<4 hours: OR 2.08 (1.29-3.35); and ≥4 hours: OR 2.71 (1.67-4.40). We conclude that prolonged second stage of labor is associated with an increased risk of low 5 minute Apgar score.

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Sandström, AnnaKarolinska Institutet (author)
Petersson, GunnarKarolinska Institutet (author)
Frisell, ThomasKarolinska Institutet (author)
Cnattingius, SvenKarolinska Institutet (author)
Stephansson, OlofKarolinska Institutet (author)
Karolinska Institutet
Karolinska Institutet
Karolinska Institutet (creator_code:org_t)

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In:European Journal of EpidemiologyStockholm : Karolinska Institutet, Dept of Medicine, Solna0393-29901573-7284

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