How long is too long: Does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes?
How long is too long: Does a prolonged second stage of labor in nulliparous women affect maternal and neonatal outcomes?
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DOI：
10.1016/j.ajog.2004.05.044
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发表时间：
2004-09-01
影响因子：
9.8
通讯作者：
Caughey, AB
中科院分区：
文献类型：
--
作者：
Cheng, YW;Hopkins, LM;Caughey, AB
目的：本研究的目的是检验产妇和新生儿的结局与第二产程间隔时间延长的关系。研究设计：这是一项在1976年至2001年间在加州大学旧金山分校进行的15,759例未分娩、足月、头位、单胎出生的回顾性队列研究。第二产程分为1小时间隔。母亲和新生儿的结局用卡方检验和学生t检验进行比较，概率值：小于或等于.05表示统计学意义。多因素Logistic回归分析控制了潜在的混杂因素。结果：剖宫产率、手术阴道分娩和会阴部损伤的增加与第一个小时以上的第二阶段相关。在多因素分析中，间隔4小时组的剖宫产率较高(优势比，5.65；P
Objective: The purpose of this study was to examine maternal and neonatal outcomes in relation to lengthening intervals of the second stage of labor.Study design: This is a retrospective cohort study of 15,759 nulliparous, term, cephalic, singleton births at the University of California, San Francisco, between 1976 and 2001. The second stage of labor was divided into 1-hour intervals. Maternal and neonatal outcomes were compared with the use of chi-squared and Student t tests, and a probability value of :less than or equal to.05 was used to indicate statistical significance. Potential confounders were controlled for with multivariate logistic regression.Results: Increasing rates of cesarean delivery, operative vaginal delivery, and perineal trauma were associated with the second stage beyond the First hour. In multivariate analysis, the >4-hour interval group had higher rates of cesarean delivery (odds ratio, 5.65; P