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BMC Pregnancy and Childbirth

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01-12-2020 | Sectio Ceasarea | Research article

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Authors: Yvette D. Miller, Ashleigh A. Armanasco, Laura McCosker, Rachel Thompson

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Abstract

Background

There is no available evidence for the prevalence of early labour admission to hospital or its association with rates of intervention and clinical outcomes in Australia. The objectives of this study were to: estimate the prevalence of early labour admission in one hospital in Australia; compare rates of clinical intervention, length of hospital stay and clinical outcomes for women admitted in early (< 4 cm cervical dilatation) or active (≥4 cm) labour; and determine the impact of recent recommendations to define early labour as < 5 cm on the findings.

Methods

We conducted a retrospective cohort study using medical record data from a random sample of 1223 women from live singleton births recorded between July 2013 and December 2015. Analyses included women who had spontaneous onset of labour at ≥37 weeks gestation whilst not a hospital inpatient, who had not scheduled a caesarean section before labour onset or delivered prior to hospital admission. Associations between timing of hospital admission in labour and clinical intervention, outcomes and hospital stay were assessed using logistic regression.

Results

Between 32.4% (< 4 cm) and 52.9% (< 5 cm) of eligible women (N = 697) were admitted to hospital in early labour. After adjustment for potential confounders, women admitted in early labour (< 4 cm) were more likely to have their labour augmented by oxytocin (AOR = 3.57, 95% CI 2.39–5.34), an epidural (AOR = 2.27, 95% CI 1.51–3.41), a caesarean birth (AOR = 3.50, 95% CI 2.10–5.83), more vaginal examinations (AOR = 1.73, 95% CI = 1.53–1.95), and their baby admitted to special care nursery (AOR = 1.54, 95% CI = 1.01–2.35). Defining early labour as < 5 cm cervical dilatation produced additional significant associations with artificial rupture of membranes (AOR = 1.41, 95% CI = 1.02–1.95), assisted vaginal birth (AOR = 1.96, 95% CI = 1.12–3.41) neonatal resuscitation (AOR = 1.73, 95% CI = 1.01–2.99) and longer maternal hospital stay (AOR = 1.21, 95% CI = 1.04–1.40).

Conclusions

Findings provide preliminary evidence that a notable proportion of labouring women are admitted in early labour and are more likely to experience several medical procedures, neonatal resuscitation and admission to special care nursery, and longer hospital stay.

July 2013 to June 2014, March 2015 to June 2015, and October 2015 to December 2015. The data collection periods were selected to allow secondary usage of the data for a different project utilising a time series design for evaluating upcoming service changes.

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Title: Variations in outcomes for women admitted to hospital in early versus active labour: an observational study
Authors: Yvette D. Miller
Ashleigh A. Armanasco
Laura McCosker
Rachel Thompson
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Sectio Ceasarea
Sectio Caesarea
Published in: BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-020-03149-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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