Evidence map›Paper›PMID 36825260›Full record

ArticleAJOG global reports2023

Maternal position during the second stage of labor and maternal-neonatal outcomes in nulliparous women: a retrospective cohort study.

Alessandra Familiari, Caterina Neri, Elvira Passananti, Giulia Di Marco, Francesca Felici, Elisa Ranieri, Maria Elena Flacco, Antonio Lanzone

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In one paragraph

Article in AJOG global reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alessandra FamiliariDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Caterina NeriDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Elvira PassanantiDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Giulia Di MarcoDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Francesca FeliciDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Elisa RanieriDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).
Maria Elena FlaccoDepartment of Medical Sciences, University of Ferrara, Ferrara, Italy (Dr Flacco).
Antonio LanzoneDepartments of Obstetrics and Gynaecology, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University of Sacred Heart, Rome, Italy (Drs Familiari, Neri, Passananti, Di Marco, and Felici, XX Ranieri, and Dr Lanzone).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe existing evidence is insufficient to draw conclusions about the association between maternal position in labor and obstetrical outcomes.

objectiveThis study aimed to evaluate the effects of different maternal positions during the second stage of labor among women with and those without epidural analgesia on important obstetrical outcomes including perineal damage. STUDY

designIn this retrospective cohort study, we collected data of women who delivered vaginally over a 2-year period. The associations between maternal and gestational characteristics and several obstetrical outcomes were analyzed. We considered perineal damage as the primary outcome. Secondary outcomes were the incidence of operative vaginal births, duration of fetal descent, intrapartum blood loss, and 1-minute and 5-minutes Apgar scores.

resultsA total of 2240 nulliparous, at-term pregnancies were included. Of those, 76.9% gave birth in a supine position and 23.1% gave birth in alternative positions. The results showed that regardless of the use of epidural analgesia, nonsupine positions in the second stage of labor are associated with a significant reduction in the risk of both episiotomy and perineal damage to any degree (

conclusionOur results show that nonsupine positions in the second stage of labor and at the time of birth are associated with a significant increase in having an intact perineum and a reduction in any perineal trauma and in the need for an episiotomy regardless of the use of epidural analgesia.

Indexed as

epidural analgesiafree birthing positionmaternal positionperineal damagesecond stage of labor

Identifiers

PMID36825260
PMCPMC9941360

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Registered trials

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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.