Observational studyAmerican journal of obstetrics and gynecology2025
More than the passage of time: neonatal health and active labor duration, the mediating role of chorioamnionitis.
Observational study in American journal of obstetrics and gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Induction of Labour with Prostaglandins: Does Their Pro-Inflammatory Effect Mimic Chorioamnionitis After PROM?Geburtshilfe und Frauenheilkunde · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundLabor intervention is intended to prevent perinatal morbidity and mortality. Labor durations traditionally defined as "dystocia" affect primary cesarean delivery rates. However, there is mixed evidence about the association between labor duration and poor neonatal outcomes. Using latent class analysis to study unknown patterns of neonatal health can refine the understanding of these relationships and the effects of labor duration on newborn outcomes.
objectiveThis study aimed to (1) identify latent classes of newborn health characteristics; (2) describe pregnancy and labor characteristics of individuals in the classes, including active labor duration; (3) determine the probability of class membership (newborn health) using labor duration and associated factors as predictors; and (4) assess direct and indirect effects of labor duration vs chorioamnionitis on neonatal risk. STUDY
designThis was a latent class analysis of 3779 term, cephalic, singleton, and nonanomalous maternal/child dyads using prospectively collected observational data.
resultsLatent class analysis of 3779 term, cephalic, singleton, and nonanomalous maternal/child dyads identified 6 neonatal phenotype classes: 4 (classes 1-4; 92% of the data) with normal neonatal outcomes and 2 (classes 5 and 6) with abnormal neonatal outcomes. Apgar scores were not related to more severe markers of neonatal well-being (neonatal intensive care unit admission, morbidity diagnosis, and failure to discharge home when the parent was discharged). Although the median labor duration was longer in classes 5 and 6, most women had labors in the lower 3 quartiles. Most births in the longest quartile of labor were associated with healthy newborn outcomes. Chorioamnionitis mediated 26% of the relationship between labor duration and newborn health phenotype.
conclusionNeonatal risk may be driven or mediated by several labor and birth factors, many of which are challenging to disaggregate. Previous research presuming longer labor duration as the driver of neonatal risk may have masked other relevant associations. More research on physiological vs pathologic inflammatory and infectious processes during term labor is crucial for advancing labor dystocia research and refining intrapartum management. Additional variables strongly correlated with labor dystocia (eg, fetal malposition) should be examined as potential mediators between longer labor and poor neonatal outcomes.
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