Grand Rounds

Does the Amount of Time Between Pregnancies Impact Labor Curves?

BACKGROUND AND PURPOSE:

There is literature suggesting longer interpregnancy intervals bring multiparous labor curves more in line with nuliparas
Longer interbirth intervals may be associated with cesarean section
Mason et al. (American Journal of Perinatology, 2018) compared labor curves between mulitiparas women with varying interpregnancy intervals

Retrospective cohort study
- Multiparous
- 13 to 60 years
- Term vaginal delivery in the studied pregnancy
- Known interbirth interval
Subjects were grouped based on interbirth intervals between the studied pregnancy and most recent birth (months)
- Group 1: 0 to 59
- Group 2: 60 to 119
- Group 3: ≥120
Interbirth interval: Defined as time between the delivery of the studied pregnancy and delivery of the most recent prior pregnancy
Labor curve slopes and intercepts as well as length of second stage were compared

250 charts were reviewed
- Data extracted, and curves developed
Groups did not differ significantly in demographic data, including BMI, parity or GA
Faster progression to full dilation in group 3 vs group 2 with the following dilation rates (p = 0.038)
- Group 1: 0.57 cm/h
- Group 2: 0.52 cm/h
- Group 3; 0.78 cm/h
Rate of dilation was comparable between groups (p = 0.38)
With Increased interbirth interval, median duration of second stage increased (p = 0.003)
- Additional 15-25 minutes

Longer interval between births is not associated with slower active phase of labor
While statistically significant, the slight increase in median duration of second stage from 15 to 25 minutes unlikely to be clinically significant
Authors conclude that increased cesarean section rates seen in previous studies looking at birth or pregnancy intervals may not be due to labor progress but rather other factors

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