ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Impact of active phase duration on neonatal and maternal adverse outcomes: A systematic analysis of parity stratification, body mass index interaction, and predictive modeling in a retrospective cohort.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. 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
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
1 citing paper in PubMed.
- Impact of active phase duration on neonatal and maternal adverse outcomes: A systematic analysis of parity stratification, body mass index interaction, and predictive modeling in a retrospective cohort.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundA prolonged active phase of labor is associated with adverse maternal and neonatal outcomes, but its clinical significance in contemporary obstetric populations, including the unique Chinese demographic context, and its modification by parity and body mass index (BMI) remain incompletely defined.
methodsA single-center retrospective cohort study included 2873 women with term (≥37 weeks), singleton, cephalic vaginal deliveries. Active phase duration (defined as time from 5 cm to 10 cm cervical dilation) was categorized into short, medium, and prolonged groups (33rd/66th percentiles). Multivariable logistic regression and restricted cubic spline (RCS) analyses were used to adjust for confounders, test interactions, and explore nonlinear trends. Predictive models incorporating active phase duration, parity, and clinical covariates were validated using area under the receiver operating characteristic curve (AUC). Primary outcomes were composite neonatal morbidity and composite maternal morbidity. Secondary outcomes included individual neonatal (e.g., neonatal intensive care unit admission and fetal distress) and maternal (e.g., postpartum hemorrhage) outcomes.
resultsAmong nulliparous women, prolonged active phase duration significantly increased risks of composite neonatal morbidity (adjusted odds ratio [aOR] 2.08, 95% confidence interval [CI] 1.23-3.52; P = 0.006), neonatal intensive care unit admission (aOR 1.97, 95% CI 1.06-3.67; P = 0.032), fetal distress (aOR 2.47, 95% CI 1.37-4.44; P = 0.003), postpartum hemorrhage (aOR 1.62, 95% CI 1.09-2.41; P = 0.018), and composite maternal morbidity (aOR 1.74, 95% CI 1.18-2.56; P = 0.005). No significant associations were observed in multiparous women. BMI modified these relationships (P interaction <0.05), with the highest risk observed in women with BMI 24.9-27.1 kg/m
conclusionProlonged active phase duration independently predicts maternal and neonatal morbidity in nulliparous women, with risk amplification in specific BMI subgroups. Parity stratification and nonlinear modeling enhance individualized labor management. Clinically applicable predictive tools integrating labor progression and maternal characteristics might optimize early intervention, reducing morbidity in modern obstetric practice.
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.