[Change of labor duration:a systematic analysis].

ABSTRACT

OBJECTIVE: To evaluate the labor duration of healthy primiparas in the past 20 years compared with Friedman labor curve. METHODS: Published observational studies about labor duration in primiparas with singleton vertex presentation were searched in PubMed, EMBase, Cochrane library, CNKI, VIP and Wanfang database. The Cochrane Collaboration's RevMan 5.1 software was used for meta-analysis. RESULTS: Eleven literatures involving 4534 primiparas were included, which were eligible for the criteria to investigate the labor duration. Meta-analysis showed that the length of active phase was significantly different between what was showed in primiparas in the past 20 years and Friedman labor curve [P = 0.01, weighted mean difference (WMD) = 1.61, 95%CI 0.38 to 2.83], and significant differences were also found in the second stage duration (P = 0.0006, WMD = -0.20, 95%CI -0.31 to -0.09). CONCLUSIONS: Compared with Friedman labor curve, active phase length of healthy primiparas in the past 20 years was significantly longer and second stage length was shorter. Reassessing labor curve of healthy primiparas is required for more scientific guidance and less unnecessary interventions.