Maternal and neonatal outcomes after prolonged latent phase

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Outcomes

Background:

• The latent phase of labor is the initial stage, characterized by cervical effacement and early dilation.
• Prolonged labor can be associated with various maternal and neonatal complications.
• Understanding the risks associated with a prolonged latent phase is crucial for clinical management.

Purpose of the Study:

• To investigate the association between a prolonged latent phase of labor and the risk of cesarean delivery.
• To examine the relationship between prolonged latent phase and other adverse maternal and neonatal outcomes.
• To identify clinical indicators for increased risk during labor.

Main Methods:

• A comparative study of 10,979 singleton vertex deliveries at or beyond 37 weeks' gestation.
• Exclusion of patients with pre-existing risk factors for adverse outcomes.
• Comparison of outcomes between patients with prolonged latent phase and those with normal latent phase.

Main Results:

• Patients with prolonged latent phase (6.5%) had significantly higher rates of labor abnormalities (42.9% vs 16.3%) and cesarean delivery (24.4% vs 6.9%).
• Increased incidence of neonatal resuscitation, thick meconium, maternal fever, low Apgar scores, NICU admission, and longer hospital stays were observed in the prolonged latent phase group.
• Multivariate analysis confirmed prolonged latent phase independently associated with increased risk for cesarean delivery (RR 1.65), need for newborn resuscitation (RR 1.37), and low 5-minute Apgar scores (RR 1.97).

Conclusions:

• Prolonged latent phase is an independent risk factor for subsequent labor abnormalities and cesarean delivery.
• A prolonged latent phase is associated with adverse neonatal outcomes, including depressed Apgar scores and the need for resuscitation.
• Clinicians should recognize prolonged latent phase as a warning sign for increased labor complications.