Effects of World Health Organization labor care guide on maternal and neonatal outcomes: A systematic review and...

Arrest in the progress of labor is one of the important cases of early cesarean section, especially in primiparous mothers, but correct diagnosis of slow progress and measures at the right time based on evidence are the most important issues in the prevalence of cesarean section during vaginal delivery.

The present study investigated the impact of the World Health Organization labor care guide (WHO LCG) on maternal and neonatal outcomes.

A comprehensive literature search was performed using PubMed, Scopus, Embase, and Google Scholar up to September 2024. Search terms included "labor care guide", "WHO obstetric guidelines", and "next-generation partogram". Studies evaluating maternal and neonatal outcomes following LCG implementation were included, with no language restrictions. The study followed PRISMA guidelines, and data were analyzed using a random-effects model.

The implementation of the WHO LCG was associated with a significant reduction in cesarean section rates (OR = 0.82; 95% CI: 0.76-0.89). It also significantly shortened the second stage of labor and decreased the need for oxytocin augmentation. No statistically significant differences were observed in severe perineal trauma or postpartum hemorrhage. Similarly, neonatal outcomes -including stillbirth, Apgar score, and admission to the neonatal intensive care unit- showed no significant changes.

The WHO LCG contributes to a measurable reduction in cesarean delivery and pharmacologic intervention rates, without increasing adverse maternal or neonatal outcomes. These findings support its broader application as a standardized approach to evidence-based intrapartum care. Further research is recommended to assess long-term neonatal impacts.