Abstract
BackgroundDystocia is one of the most frequent causes of cesarean delivery in nulliparous women. Despite this, its causes are largely unknown. Vitamin D receptor (VDR) has been found in the myometrium. Thus, it is possible that vitamin D affects the contractility of the myometrium and may be involved in the pathogenesis of dystocia. Seasonal variation of dystocia in areas with distinct seasonal variation in sunlight exposure, like Denmark, could imply that vitamin D may play a role. This study examined whether there was seasonal variation in the incidence of dystocia in a Danish population.MethodWe used information from a cohort of 34,261 nulliparous women with singleton pregnancies, spontaneous onset of labor between 37 and 42 completed gestational weeks, and vertex fetal presentation. All women gave birth between 1992 and 2010 at the Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby. Logistic regression combined with cubic spline was used to estimate the seasonal variation for each outcome after adjusting for calendar time.ResultsNo evidence for seasonal variation was found for any of the outcomes: acute cesarean delivery due to dystocia (p = 0.44); instrumental vaginal delivery due to dystocia (p = 0.69); oxytocin augmentation due to dystocia (p = 0.46); and overall dystocia (p = 0.91).ConclusionNo seasonal variation in the incidence of dystocia was observed in a large cohort of Danish women. This may reflect no association between vitamin D and dystocia, or alternatively that other factors with seasonal variation and influence on the occurrence of dystocia attenuate such an association.
Highlights
Dystocia is defined as slow, abnormal progression of labor [1,2,3]
No seasonal variation in the incidence of dystocia was observed in a large cohort of Danish women
This may reflect no association between vitamin D and dystocia, or alternatively that other factors with seasonal variation and influence on the occurrence of dystocia attenuate such an association
Summary
Dystocia is defined as slow, abnormal progression of labor [1,2,3]. It is the result of problems related to either the passenger, such as abnormal fetal presentation; the passage, such as absolute or relative cephalopelvic disproportion; or the power, such as insufficient uterine activity [1].Known risk factors for dystocia include nulliparity, labor induction, high maternal age, short stature [1,4,5], postterm gestation, high birth weight and abnormal vertex presentation. [4,5]. Dystocia is defined as slow, abnormal progression of labor [1,2,3] It is the result of problems related to either the passenger, such as abnormal fetal presentation; the passage, such as absolute or relative cephalopelvic disproportion; or the power, such as insufficient uterine activity [1].Known risk factors for dystocia include nulliparity, labor induction, high maternal age, short stature [1,4,5], postterm gestation, high birth weight and abnormal vertex presentation. This study examined whether there was seasonal variation in the incidence of dystocia in a Danish population
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