Changes in labor patterns over 50 years.

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

CONCLUSION: Labor is longer in the modern obstetrical cohort. The benefit of extensive interventions needs further evaluation. Published by Mosby, Inc. 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. 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/m(2)), 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. 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).


English

0002-9378


*Delivery, Obstetric/td [Trends]
*Labor, Obstetric/ph [Physiology]
Adult
Age Factors
Body Mass Index
Delivery, Obstetric/mt [Methods]
Delivery, Obstetric/sn [Statistics & Numerical Data]
Female
Humans
Labor Stage, First
Labor Stage, Second
Linear Models
Multivariate Analysis
Parity
Physician's Practice Patterns
Pregnancy
Pregnancy Outcome
Retrospective Studies
Time Factors
United States


MedStar Washington Hospital Center


Obstetrics and Gynecology, Maternal-Fetal Medicine


Journal Article
Research Support, N.I.H., Intramural