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#Grand Rounds

Does the Amount of Time Between Pregnancies Impact Labor Curves?

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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

METHODS:

  • 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

RESULTS:

  • 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

CONCLUSION:

  • 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

Learn More – Primary Sources:

Labor Curves in Multiparous Women Related to Interbirth Intervals

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Related ObG Topics:

Does Maternal Age Modify the Risk Associated with Short Interpregnancy Interval?
Interpregnancy Interval and Adverse Perinatal Outcomes 
Conceiving After Pregnancy Loss – Is Waiting Beneficial?  
Could New Labor Management Guidelines be Doing More Harm than Good?

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