ArticleActa obstetricia et gynecologica Scandinavica2024
Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study.
Article in Acta obstetricia et gynecologica Scandinavica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- A Mobilisation Protocol in the Management of Posterior Foetal Presentations: A Multicentre Observational Pilot Study.Healthcare (Basel, Switzerland) · 2026Article
- Fetal rotation examined with ultrasound.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Effects of free-position delivery combined with perineal massage on reducing sensitive indicators of care quality in high-risk pregnant women.Frontiers in medicine · 2025Article
- Fetal rotation examined with ultrasound in a sub-Saharan population: A longitudinal cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Associations between fetal position at delivery and duration of active phase of labor: A historical cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
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6 authors.
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Abstract
introductionIn clinical experience, occiput posterior (OP) position is associated with longer labor duration than occiput anterior (OA) position, but few studies have investigated the association between labor duration and fetal position. We aimed to compare duration of the active phase of labor in OP deliveries with OA deliveries in a contemporary population using survival methods. Secondary aims were to compare the frequencies of operative interventions, obstetric anal sphincter injuries (OASIS), postpartum hemorrhage, and newborn outcomes in OP with OA deliveries. MATERIAL AND
methodsWe did a historical cohort study in three university hospitals in Norway from 2012 to 2022. Women with a single fetus in cephalic presentation, no previous cesarean section and gestational age ≥37 weeks were eligible and stratified into the first four groups of the Robson ten-group classification system (TGCS). We estimated the mean duration and calculated the hazard ratio (HR) for delivery using survival analyses. Cesarean sections and instrumental vaginal deliveries were censored.
resultsThe study population comprised 112 019 women, 105 571 (94.2%) were delivered in OA and 6448 (5.8%) in OP position. The estimated mean duration of the active phase of labor was longer in women with the fetus in OP position in all four TGCS groups. The estimated duration was longer in the OP groups in analyses stratified with respect to epidural analgesia and oxytocin augmentation. The graphical abstract illustrates the probability of delivery in OP compared with OA position in merged TGCS groups 1 and 2a, as a function of time. The unadjusted HR was 0.33 (95% CI 0.31-0.36) for fetuses delivered in OP position compared with OA position in TGCS group 1, 0.25 (95% CI 0.21-0.27) in group 2a, 0.70 (95% CI 0.67-0.73) in group 3, and 0.61 (95% CI 0.55-0.67) in group 4a, respectively. Neither maternal age, gestational age, BMI nor birthweight had confounding effect. Operative delivery rates and OASIS rates were higher in OP position in all four groups.
conclusionsWe found longer duration of the active phase of labor in women with the fetus delivered in OP position in all four TGCS groups.
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