ArticleJournal of perinatology : official journal of the California Perinatal Association2017
Durations of second stage of labor and pushing, and adverse neonatal outcomes: a population-based cohort study.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Evaluating the impact of the second-stage and pushing duration on maternal and neonatal outcomes: a systematic review and meta-analysis.American journal of obstetrics and gynecology · 2025Pooled it
- Umbrella review and meta-analysis of the effect of delayed and immediate pushing in the second stage of labor on neonatal outcomes.Archives of gynecology and obstetrics · 2025Pooled it
- Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Relationship Between Prolonged Second Stage of Labor and Short-Term Neonatal Morbidity: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Intrapartum uterine activity and neonatal outcomes: a systematic review.BMC pregnancy and childbirth · 2020Pooled it
- An attempt to improve recognition of fetal acidemia by a remodeled intrapartum cardiotocography classification: A case-control study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Long-term neurodevelopmental outcomes after vacuum-assisted delivery: A population-based cohort study.PLoS medicine · 2026Article
- Magnitude of Adverse Birth Outcomes and Predictors Among Newborns Delivered at Public Hospitals in Benadir Region, Somalia.Journal of epidemiology and global health · 2026Article
- Prolonged Second Stage of Labor in Thai Women: A Retrospective Cohort Study.International journal of women's health · 2026Article
- Influence of the active second stage of labor in nulliparous women on umbilical cord blood pH and neonatal outcomes: a population-based, cohort study.BMC pregnancy and childbirth · 2025Article
- Association between labor duration in transvaginal deliveries and the risk of neonatal intensive care unit admission for newborns.Frontiers in pediatrics · 2025Article
- Determinants of Birth Asphyxia Among Newborns at a Tertiary Care Hospital, Central Ethiopia: A Case-Control Study.BioMed research international · 2025Article
- Analysis of Maternal Positions during the Dilation and Expulsive Phase and Their Relationship with Perineal Injuries in Eutocic Deliveries Attended by Midwives.Healthcare (Basel, Switzerland) · 2024Article
- Psyche: The 5th 'P' and its Associated Impact on the Second Stage of Labor.Rhode Island medical journal (2013) · 2024Article
- Dual-modal Photoacoustic and Ultrasound Imaging: from preclinical to clinical applications.Frontiers in photonics · 2024Article
- Endorphins, Sexuality, and Reproduction.Advances in neurobiology · 2024Article
- First stage of labour duration and associated risk of adverse neonatal outcomes.Scientific reports · 2023Article
- Maternal and perinatal outcomes of prolonged second stage of labour: a historical cohort study of over 51,000 women.BMC pregnancy and childbirth · 2023Article
- Adverse neonatal outcomes and associated factors among mothers who gave birth through induced and spontaneous labor in public hospitals of Awi zone, Northwest Ethiopia: a comparative cross-sectional study.BMC pregnancy and childbirth · 2023Article
- Latent phase duration and associated outcomes: a contemporary, population-based observational study.American journal of obstetrics and gynecology · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe associations between duration of second stage of labor, pushing time and risk of adverse neonatal outcomes are not fully established. Therefore, we aimed to examine such relationships. STUDY
designA population-based cohort study including 42 539 nulliparous women with singleton infants born in cephalic presentation at ⩾37 gestational weeks, using the Stockholm-Gotland Obstetric Cohort, Sweden, and the Swedish Neonatal Quality Register, 2008 to 2013. Poisson regression was used to analyze estimated adjusted relative risks (RRs), with 95% confidence intervals (CIs). Outcome measures were umbilical artery acidosis (pH <7.05 and base excess <-12), birth asphyxia-related complications (including any of the following conditions: hypoxic ischemic encephalopathy, hypothermia treatment, neonatal seizures, meconium aspiration syndrome or advanced resuscitation after birth) and admission to neonatal intensive care unit (NICU).
resultsOverall rates of umbilical artery acidosis, birth asphyxia-related complications and admission to NICU were 1.08, 0.63 and 6.42%, respectively. Rate of birth asphyxia-related complications gradually increased with duration of second stage: from 0.42% at <1 h to 1.29% at ≥4 h (adjusted RR 2.46 (95% CI 1.66 to 3.66)). For admission to NICU, corresponding rates were 4.97 and 9.45%, and adjusted RR (95% CI) was 1.80 (95% CI 1.58 to 2.04). Compared with duration of pushing <15 min, a duration of pushing ⩾60 min increased rates of acidosis from 0.57 to 1.69% (adjusted RR 2.55 (95% CI 1.51 to 4.30)).
conclusionProlonged durations of second stage of labor and pushing are associated with increased RRs of adverse neonatal outcomes. Clinical assessment of fetal well-being is essential when durations of second stage and pushing increases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.