Analysis of the outcomes and factors influencing vaginal trial labor in primiparas at term.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-12-04 DOI:10.1007/s00404-024-07816-4
Songwen Nian, Huixia Yang, Yumei Wei
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Abstract

Purpose: To explore the outcomes and factors influencing vaginal trial labor in primiparas with term singleton fetuses.

Methods: A retrospective analysis of 9174 first-time mothers who opted for a vaginal trial of labor at Peking University First Hospital from October 2019 to September 2022 was performed. The primary outcomes included the outcome of the trial of labor and influencing factors.

Results: Of the total population, the success rate of attempted vaginal delivery was 74.3% (6818/9174). Logistic regression analysis revealed that increasing maternal age (OR = 1.054; 95% CI = 1.239-2.316; p < 0.001), gestational weight gain (OR = 1.033; 95% CI = 1.022-1.045; p < 0.001), neonatal weight (OR = 1.971; 95% CI = 1.724-2.253; p < 0.001), prepregnancy body mass index (BMI) ≥ 24 kg/m2 (OR = 1.605; 95% CI = 1.411-1.825; p < 0.001), prenatal BMI ≥ 24 kg/m2 (OR = 1.326; 95% CI = 1.137-1.546; p < 0.001), and induced labor (OR = 2.434; 95% CI = 2.187-2.708; p < 0.001) increased the risk of failed vaginal delivery attempts, and labor analgesia reduced the risk of failed vaginal delivery attempts (OR = 0.356; 95% CI = 0.320-0.397; p < 0.001). However, the use of assisted reproductive technology had no significant effect on the outcome of attempted vaginal delivery (p = 0.137). According to the partial regression coefficient, the area under the ROC curve was 0.710 (95% CI = 0.698-0.723), and the model passed the Hosmer-Lemeshow test and had good discrimination and calibration (χ2 = 12.833, p = 0.118). The postpartum hemorrhage (PPH) rate and overall neonatal asphyxia rate differed significantly between women who had different outcomes of vaginal trial labor.

Conclusions: There are many factors affecting the occurrence of abnormal delivery in primiparas. These independent factors can be used for prenatal evaluation.

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初产妇足月阴道试产结局及影响因素分析。
目的:探讨影响单胎足月初产妇阴道试产的因素及结局。方法:回顾性分析2019年10月至2022年9月北京大学第一医院9174例选择阴道试产的产妇。主要结局包括产程试验结果及影响因素。结果:阴道分娩成功率为74.3%(6818/9174)。Logistic回归分析显示,产妇年龄增加(OR = 1.054;95% ci = 1.239-2.316;p 2 (OR = 1.605;95% ci = 1.411-1.825;p 2 (OR = 1.326;95% ci = 1.137-1.546;P = 12.833, P = 0.118)。产后出血(PPH)率和新生儿窒息率在阴道试产不同结局的妇女之间有显著差异。结论:影响初产妇异常分娩的因素很多。这些独立因素可用于产前评估。
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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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