title: [In which position do women give birth in 2015? Results from a prospective multicenter study].
abstract: OBJECTIVE
  To assess the frequency of labor and birth positions in 2015, and identify factors associated with choosing and changing position during labor.
  
  
  METHODS
  Multicenter prospective study during five weeks in 2015. We collected the distribution of the observed positions during the first and second stage of labor. Then we considered the main birth position as the one used for the longest duration. Factors associated to the main birth position as well as to the changes of position during labor were studied using univariate analysis and the role of each factor was analyzed using multilevel logistic regression.
  
  
  RESULTS
  Among women who delivered, 86.1% did so in gynecological position. There was a center effect for the position during the expulsive phase, which was not related to legal status or level of perinatal care. After adjustment, a labor duration shorter than 2hours was associated to dorsal decubitus during labor (OR=2.1 95%CI [1.01-4.3]). Prematurity and labor duration less than 2hours decreased the occurrence of changes in position during labor: OR=0.05 95%CI [0.01-0.2] and OR=0.2 95%CI [0.1-0.3]. Epidural analgesia was associated to change in birth position during labor: (OR=2.1 95%CI [1.2-3.8]). During the expulsive phase, primiparity and labor duration less than 2hours were associated to dorsal decubitus position (OR=3.6 95%CI [1.2-10.8]).
  
  
  CONCLUSIONS
  Women still mostly deliver in gynecological position in 2015. A systematic collection of birth positions on the partograph, with an acute definition of these positions, could allow an evaluation of the benefits/disadvantages of the different positions currently available.
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Institut Prime UPR 3346-CNRS, Axe RoBioSS, université de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France. Electronic address: david.desseauve@univ-poitiers.fr.
authors.forename: D
authors.initials: D
authors.lastname: Desseauve
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Institut Prime UPR 3346-CNRS, Axe RoBioSS, université de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors.forename: B
authors.initials: B
authors.lastname: Gachon
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Bertherat
authors.affiliation: Institut Prime UPR 3346-CNRS, Axe RoBioSS, université de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors.forename: L
authors.initials: L
authors.lastname: Fradet
authors.affiliation: Institut Prime UPR 3346-CNRS, Axe RoBioSS, université de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Lacouture
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France.
authors.forename: F
authors.initials: F
authors.lastname: Pierre
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D010298:Parity; D036801:Parturition; D011187:Posture; D011247:Pregnancy; D011248:Pregnancy Complications; D047928:Premature Birth; D011446:Prospective Studies; D013997:Time Factors
keywords: Accouchement; Birth; Birth position; Delivery; Epidemiology; Grossesse; Labor; Naissance; Position d’accouchement; Pregnancy; Travail obstétrical; Épidémiologie