Abstract
(1) Background: To assess the relationship between the duration of the second stage of labour and the neonatal morbidity risk; (2) Methods: An observational, analytical, retrospective cohort study was performed at the “Mancha-Centro” Hospital (Spain) during the 2013–2016 period. Data were collected from 3863 women who gave a vaginal birth. The studied neonatal morbidity variables were umbilical cord arterial pH, 5-min Apgar score, need for advanced neonatal resuscitation, and a composite neonatal morbidity variable on which the multivariate analysis was done. A univariate analysis was used for the potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors; (3) Results: The univariate analysis showed a statistically significant relationship between the duration of the second stage of labour and a high risk of advanced neonatal resuscitation and composite neonatal morbidity in multiparous women. However, after performing the multivariate analysis for the variable “composite neonatal morbidity”, we observed no relationship with the duration of the second stage of labour in either nulliparous or multiparous women; (4) Conclusions: The duration of the second stage of labour was not related to an increased risk of neonatal morbidity in our study population.
Highlights
The second stage of labour begins when the cervix becomes fully dilated and ends with the delivery of the neonate [1]
The second stage of labour is characterised by an increasing number and intensity of uterine contractions with respect to the first stage of labour, as well as an increase in maternal bearing down efforts, which leads to maternal fatigue and high foetal lactic acid levels [4]
Once the univariate analysis was performed considering the potential risk factors, and the variables were used as the neonatal morbidity criteria according to parity, we observed a statistically significant relationship in both the nulliparous and multiparous women (p ≤ 0.05) between the duration of the first stage of labour and the degree of advanced neonatal resuscitation, as well as with composite morbidity
Summary
The second stage of labour begins when the cervix becomes fully dilated and ends with the delivery of the neonate [1]. Managing the second stage of labour is a constant challenge for professionals in the clinical practice [2]. The main objective of this stage of labour is to lower caesarean section rates, increase the possibility of vaginal birth and, in turn, avoid adverse effects for both the mother and the newborn [2,3]. The second stage of labour is characterised by an increasing number and intensity of uterine contractions with respect to the first stage of labour, as well as an increase in maternal bearing down efforts, which leads to maternal fatigue and high foetal lactic acid levels [4]. The presence or combination of these factors means that the second stage of labour is a very stressful period for the foetus
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