PMID- 36795737
OWN - NLM
STAT- MEDLINE
DCOM- 20230222
LR  - 20230407
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 2
DP  - 2023
TI  - Timing of hospital admission at first childbirth: A prospective cohort study.
PG  - e0281707
LID - 10.1371/journal.pone.0281707 [doi]
LID - e0281707
AB  - BACKGROUND AND AIMS: It is difficult for women in labor to determine when best to 
      present for hospital admission, particularly at first childbirth. While it is 
      often recommended that women labor at home until their contractions have become 
      regular and </= 5-minutes apart, little research has investigated the utility of 
      this recommendation. This study investigated the relationship between timing of 
      hospital admission, in terms of whether women's labor contractions had become 
      regular and </= 5-minutes apart before admission, and labor progress. METHODS: This 
      was a cohort study of 1,656 primiparous women aged 18-35 years with singleton 
      pregnancies who began labor spontaneously at home and delivered at 52 hospitals 
      in Pennsylvania, USA. Women who were admitted before their contractions had 
      become regular and </= 5-minutes apart (early admits) were compared to those who 
      were admitted after (later admits). Multivariable logistic regression models were 
      used to assess associations between timing of hospital admission and active labor 
      status on admission (cervical dilation 6-10 cm), oxytocin augmentation, epidural 
      analgesia and cesarean birth. RESULTS: Nearly two-thirds of the participants 
      (65.3%) were later admits. These women had labored for a longer time period 
      before admission (median, interquartile range [IQR] 5 hours (3-12 hours)) than 
      the early admits (median, (IQR) 2 hours (1-8 hours), p < 0.001); were more likely 
      to be in active labor on admission (adjusted OR [aOR] 3.78, 95% CI 2.47-5.81); 
      and were less likely to experience labor augmentation with oxytocin (aOR 0.44, 
      95% CI 0.35-0.55); epidural analgesia (aOR 0.52, 95% CI 0.38-0.72); and cesarean 
      birth (aOR 0.66, 95% CI 0.50-0.88). CONCLUSIONS: Among primiparous women, those 
      who labor at home until their contractions have become regular and </= 5-minutes 
      apart are more likely to be in active labor on hospital admission and less likely 
      to experience oxytocin augmentation, epidural analgesia and cesarean birth.
CI  - Copyright: (c) 2023 Kjerulff et al. This is an open access article distributed 
      under the terms of the Creative Commons Attribution License, which permits 
      unrestricted use, distribution, and reproduction in any medium, provided the 
      original author and source are credited.
FAU - Kjerulff, Kristen H
AU  - Kjerulff KH
AUID- ORCID: 0000-0002-5376-2581
AD  - Department of Public Health Sciences, College of Medicine, Penn State University, 
      Hershey, Pennsylvania, United States of America.
AD  - Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical 
      Center, Hershey, Pennsylvania, United States of America.
FAU - Attanasio, Laura B
AU  - Attanasio LB
AD  - School of Public Health and Health Sciences, University of Massachusetts Amherst, 
      Amherst, Massachusetts, United States of America.
FAU - Vanderlaan, Jennifer
AU  - Vanderlaan J
AD  - School of Nursing, University of Nevada, Las Vegas, Nevada, United States of 
      America.
FAU - Sznajder, Kristin K
AU  - Sznajder KK
AD  - Department of Public Health Sciences, College of Medicine, Penn State University, 
      Hershey, Pennsylvania, United States of America.
LA  - eng
GR  - R01 HD052990/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20230216
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 50-56-6 (Oxytocin)
SB  - IM
MH  - Pregnancy
MH  - Female
MH  - Humans
MH  - *Oxytocin
MH  - Cohort Studies
MH  - Prospective Studies
MH  - *Labor, Obstetric
MH  - Hospitals
PMC - PMC9934383
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/02/17 06:00
MHDA- 2023/02/22 06:00
PMCR- 2023/02/16
CRDT- 2023/02/16 13:44
PHST- 2022/11/03 00:00 [received]
PHST- 2023/01/30 00:00 [accepted]
PHST- 2023/02/16 13:44 [entrez]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/22 06:00 [medline]
PHST- 2023/02/16 00:00 [pmc-release]
AID - PONE-D-22-30383 [pii]
AID - 10.1371/journal.pone.0281707 [doi]
PST - epublish
SO  - PLoS One. 2023 Feb 16;18(2):e0281707. doi: 10.1371/journal.pone.0281707. 
      eCollection 2023.