Factors associated with non-normal birth outcomes for low-risk women in an inner-city hospital.
BACKGROUND
The purpose of this study was to examine factors associated with normal versus non-normal birth outcomes for low-risk women who were admitted for care in spontaneous labor.


METHODS
The birth records of 93 women were reviewed.


RESULTS
At the completion of the fourth stage of labor, 61% of births (n = 57) met the criteria for normal, while 39% of births (n = 36) had non-normal outcomes. On bivariate analysis, variables associated with non-normal outcomes included nulliparity (odds ratio [OR], 9.10; 95% confidence interval [CI], 3-28; P < .0001), lower average centimeters of dilation at admission (t-score 4.422; P < .001), use of pharmacologic pain relief, including narcotics and epidural anesthesia (OR, 5.03; 95% CI, 2-16; P = .005), and birth attended by a physician versus a certified nurse-midwife (OR, 3.60; 95% CI, 2-9; P = .004). In a multivariate analysis, nulliparity (OR, 6.07; 95% CI, 2-19; P = .002) and lower average centimeters of dilation at admission (OR, 0.63; 95% CI, 0.5-0.9; P = .005) were independently associated with non-normal outcome.


CONCLUSIONS
The development of clinical guidelines aimed at reducing admissions of women in early labor may reduce non-normal outcomes, particularly for nulliparous women.
McDermott
Anne M
AM
Anne.McDermott@NorwalkHealth.org <Anne.McDermott@NorwalkHealth.org>
D000293:Adolescent; D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D002947:Cities; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D016015:Logistic Models; D008880:Midwifery / Q000706:statistics & numerical data*; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D009774:Obstetrics / Q000706:statistics & numerical data*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult