Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study
Abstract Background To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Methods Cohort study from a university hospital in Sweden betw...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-017-1556-5 |
| _version_ | 1818506387108397056 |
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| author | Kristina Dahlqvist Maria Jonsson |
| author_facet | Kristina Dahlqvist Maria Jonsson |
| author_sort | Kristina Dahlqvist |
| collection | DOAJ |
| description | Abstract Background To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Methods Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH < 7.00 and <7.10 and short-term neonatal morbidity. The association between occiput posterior position and neonatal outcomes was examined using logistic regression analysis, presented as adjusted odds ratio (AOR) with 95% confidence interval (CI). Results Of 27,648 attempted vaginal births, 1292 (4.7%) had occiput posterior position. Compared with occiput anterior, there was no difference in pH < 7.00 (0.4% vs. 0.5%) but a higher rate of pH < 7.10 in occiput posterior births (3.8 vs. 5.5%). Logistic regression analysis showed no increased risk of pH < 7.10 (AOR 1.28 95% CI 0.93–1.74) when occiput posterior was compared with occiput anterior births but, an increased risk of Apgar score < 7 at 5 min (AOR 1.84, 95% CI 1.11–3.05); neonatal care admission (AOR 1.68, 95% CI 1.17–2.42) and composite morbidity (AOR 1.66, 95% CI 1.19–2.31). Conclusions With delayed pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies. |
| first_indexed | 2024-12-10T22:03:52Z |
| format | Article |
| id | doaj.art-1d631d6d2ff745fe8f79ff0352b08dff |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-10T22:03:52Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-1d631d6d2ff745fe8f79ff0352b08dff2022-12-22T01:31:49ZengBMCBMC Pregnancy and Childbirth1471-23932017-11-011711710.1186/s12884-017-1556-5Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort studyKristina Dahlqvist0Maria Jonsson1Department of Women’s and Children’s Health, Uppsala UniversityDepartment of Women’s and Children’s Health, Uppsala UniversityAbstract Background To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Methods Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH < 7.00 and <7.10 and short-term neonatal morbidity. The association between occiput posterior position and neonatal outcomes was examined using logistic regression analysis, presented as adjusted odds ratio (AOR) with 95% confidence interval (CI). Results Of 27,648 attempted vaginal births, 1292 (4.7%) had occiput posterior position. Compared with occiput anterior, there was no difference in pH < 7.00 (0.4% vs. 0.5%) but a higher rate of pH < 7.10 in occiput posterior births (3.8 vs. 5.5%). Logistic regression analysis showed no increased risk of pH < 7.10 (AOR 1.28 95% CI 0.93–1.74) when occiput posterior was compared with occiput anterior births but, an increased risk of Apgar score < 7 at 5 min (AOR 1.84, 95% CI 1.11–3.05); neonatal care admission (AOR 1.68, 95% CI 1.17–2.42) and composite morbidity (AOR 1.66, 95% CI 1.19–2.31). Conclusions With delayed pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies.http://link.springer.com/article/10.1186/s12884-017-1556-5AcidaemiaApgar scoreCaesarean deliveryDelayed pushingMetabolic acidaemiaLabour |
| spellingShingle | Kristina Dahlqvist Maria Jonsson Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study BMC Pregnancy and Childbirth Acidaemia Apgar score Caesarean delivery Delayed pushing Metabolic acidaemia Labour |
| title | Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study |
| title_full | Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study |
| title_fullStr | Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study |
| title_full_unstemmed | Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study |
| title_short | Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study |
| title_sort | neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced a cohort study |
| topic | Acidaemia Apgar score Caesarean delivery Delayed pushing Metabolic acidaemia Labour |
| url | http://link.springer.com/article/10.1186/s12884-017-1556-5 |
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