title: Primiparity: a traditional intrapartum obstetric risk reconfirmed.
abstract: BACKGROUND
  Intrapartum risk is based mainly on obstetric history, which is lacking in primiparous women.
  
  
  OBJECTIVE
  To ascertain whether the traditional known risk of primiparity is an independent variable for both maternal and neonatal outcome.
  
  
  METHODS
  All women admitted to labor during March-April 2002 were canvassed for eligibility to participate in the study based on an obstetric risk scoring system developed and validated for our population. During the study period, 1473 women presented for delivery. Of these, 298 (20%) were eligible according to the exclusion criteria as "low risk" parturients: 135 (45%) were primiparous and 163 (55%) were multiparous (2-5 births).
  
  
  RESULTS
  After correction for significant confounding factors, primiparity was revealed as an independent significant risk factor for instrumental delivery (odds ratio 15.5, 95%confidence interval 1.88-125) and for early postpartum hemorrhage (OR 5.6, 95%CI 1.9-16.6).
  
  
  CONCLUSIONS
  This study highlights early postpartum hemorrhage as a significant risk for primiparous women, independent of mode of delivery, and also confirms previous reports of maternal complications requiring transfer from birth centers/home deliveries to tertiary centers.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel. malkiel.avishay@gmail.com
authors.forename: Avishay
authors.initials: A
authors.lastname: Malkiel
authors.forename: Mor
authors.initials: M
authors.lastname: Pnina
authors.forename: Haim
authors.initials: H
authors.lastname: Aloni
authors.forename: Efraim
authors.initials: E
authors.lastname: Gdansky
authors.forename: Sorina
authors.initials: S
authors.lastname: Grisaru-Granovsky