Factors Associated With Non-Normal Birth Outcomes for Low-Risk Women in an Inner-City Hospital
Version of Record online: 24 DEC 2010
2010 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 55, Issue 2, pages 101–106, March-April 2010
How to Cite
McDermott, A. M. (2010), Factors Associated With Non-Normal Birth Outcomes for Low-Risk Women in an Inner-City Hospital. Journal of Midwifery & Womens Health, 55: 101–106. doi: 10.1016/j.jmwh.2009.07.003
- Issue online: 24 DEC 2010
- Version of Record online: 24 DEC 2010
- obstetric delivery;
- obstetric labor;
- obstetric labor complications;
- pregnancy outcome
Introduction: 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.
Discussion: The development of clinical guidelines aimed at reducing admissions of women in early labor may reduce non-normal outcomes, particularly for nulliparous women.