Does dystocia during labor pose a risk factor for another non-progressive labor during the subsequent delivery?

To establish whether failure to progress during labor poses a risk factor for another non-progressive labor (NPL) during the subsequent delivery.

A retrospective cohort study including singleton pregnancies that failed to progress during the previous labor and resulted in a cesarean section (CS) was conducted. Parturients were classified into three groups for both previous and subsequent labors: CS due to NPL stage I, stage II and an elective CS as a comparison group.

Of 202 462 deliveries, 10 654 women met the inclusion criteria: 3068 women were operated due to NPL stage I and 1218 due to NPL stage II. The comparison group included 6368 women. Using a multivariable logistic regression models, NPL stage I during the previous delivery was found as an independent risk factor for another NPL stage I in the subsequent labor (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI] = 2.4-3.7; p < 0.001). Similarly, NPL at stage I or II was found to be an independent risk factor for a NPL stage II during the subsequent labor (adjusted OR = 1.4; 95% CI = 1.1-2.1; p = 0.033; adjusted OR = 5.3; 95% CI = 3.7-7.5; p < 0.001; respectively).

A previous CS due to a NPL is an independent risk factor for another NPL in the subsequent pregnancy and for recurrent cesarean delivery.