Associated factors and outcomes of persistent occiput posterior position: A retrospective cohort study from 1976 to 2001

Yvonne W. Cheng, Brian Shaffer, Aaron Caughey

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective. To identify maternal and fetal risk factors associated with persistent occiput posterior position at delivery, and to examine the association of occiput posterior position with subsequent obstetric outcomes. Methods. This is a retrospective cohort study of 30 839 term, cephalic, singleton births. Women with persistent occiput posterior (OP) position at delivery were compared to those with occiput anterior (OA) position. Demographics, obstetric history, and labor management were evaluated and subsequent obstetric outcomes examined. Potential confounding variables were controlled for using multivariate logistic regression analysis. Results. The overall frequency of OP position was 8.3% in the study population. When compared to Caucasians, a higher rate of OP was observed among African-Americans (OR=1.4, 95% CI 1.25-1.64) while no other racial/ethnic differences were noted. Other associated factors included nulliparity, maternal age ≥35, gestational age ≥41 weeks, and birth weight >4000g, as well as artificial rupture of the membranes (AROM) and epidural anesthesia (p <0.001 for all). Persistent OP was associated with increased rates of operative vaginal (OR=4.14, 95% CI 3.57-4.81) and cesarean deliveries (OR=13.45, 95% CI 11.94-15.15) and other peripartum complications including third or fourth degree perineal lacerations (OR=2.38, 95% CI 2.03-2.79), and chorioamnionitis (OR=2.10, 95% CI 1.81-2.44). Conclusion. Epidural use, AROM, African-American ethnicity, nulliparity, and birth weight >4000g are associated with persistent OP position at delivery, with higher rates of operative deliveries and obstetric complications. This information can be useful in counseling patients regarding risks and associated outcomes of persistent OP position.

Original languageEnglish (US)
Pages (from-to)563-568
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume19
Issue number9
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Fingerprint

Obstetrics
Obstetric Labor
Cohort Studies
Obstetric Delivery
Retrospective Studies
Artificial Membranes
Confounding Factors (Epidemiology)
Epidural Anesthesia
Maternal Age
Parity
Birth Weight
African Americans
Gestational Age
Counseling
Rupture
Logistic Models
History
Head
Regression Analysis
Mothers

Keywords

  • Maternal outcome
  • Persistent OP position

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

@article{6191e3cc74aa44eeace77443d111c71b,
title = "Associated factors and outcomes of persistent occiput posterior position: A retrospective cohort study from 1976 to 2001",
abstract = "Objective. To identify maternal and fetal risk factors associated with persistent occiput posterior position at delivery, and to examine the association of occiput posterior position with subsequent obstetric outcomes. Methods. This is a retrospective cohort study of 30 839 term, cephalic, singleton births. Women with persistent occiput posterior (OP) position at delivery were compared to those with occiput anterior (OA) position. Demographics, obstetric history, and labor management were evaluated and subsequent obstetric outcomes examined. Potential confounding variables were controlled for using multivariate logistic regression analysis. Results. The overall frequency of OP position was 8.3{\%} in the study population. When compared to Caucasians, a higher rate of OP was observed among African-Americans (OR=1.4, 95{\%} CI 1.25-1.64) while no other racial/ethnic differences were noted. Other associated factors included nulliparity, maternal age ≥35, gestational age ≥41 weeks, and birth weight >4000g, as well as artificial rupture of the membranes (AROM) and epidural anesthesia (p <0.001 for all). Persistent OP was associated with increased rates of operative vaginal (OR=4.14, 95{\%} CI 3.57-4.81) and cesarean deliveries (OR=13.45, 95{\%} CI 11.94-15.15) and other peripartum complications including third or fourth degree perineal lacerations (OR=2.38, 95{\%} CI 2.03-2.79), and chorioamnionitis (OR=2.10, 95{\%} CI 1.81-2.44). Conclusion. Epidural use, AROM, African-American ethnicity, nulliparity, and birth weight >4000g are associated with persistent OP position at delivery, with higher rates of operative deliveries and obstetric complications. This information can be useful in counseling patients regarding risks and associated outcomes of persistent OP position.",
keywords = "Maternal outcome, Persistent OP position",
author = "Cheng, {Yvonne W.} and Brian Shaffer and Aaron Caughey",
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TY - JOUR

T1 - Associated factors and outcomes of persistent occiput posterior position

T2 - A retrospective cohort study from 1976 to 2001

AU - Cheng, Yvonne W.

AU - Shaffer, Brian

AU - Caughey, Aaron

PY - 2006/9/1

Y1 - 2006/9/1

N2 - Objective. To identify maternal and fetal risk factors associated with persistent occiput posterior position at delivery, and to examine the association of occiput posterior position with subsequent obstetric outcomes. Methods. This is a retrospective cohort study of 30 839 term, cephalic, singleton births. Women with persistent occiput posterior (OP) position at delivery were compared to those with occiput anterior (OA) position. Demographics, obstetric history, and labor management were evaluated and subsequent obstetric outcomes examined. Potential confounding variables were controlled for using multivariate logistic regression analysis. Results. The overall frequency of OP position was 8.3% in the study population. When compared to Caucasians, a higher rate of OP was observed among African-Americans (OR=1.4, 95% CI 1.25-1.64) while no other racial/ethnic differences were noted. Other associated factors included nulliparity, maternal age ≥35, gestational age ≥41 weeks, and birth weight >4000g, as well as artificial rupture of the membranes (AROM) and epidural anesthesia (p <0.001 for all). Persistent OP was associated with increased rates of operative vaginal (OR=4.14, 95% CI 3.57-4.81) and cesarean deliveries (OR=13.45, 95% CI 11.94-15.15) and other peripartum complications including third or fourth degree perineal lacerations (OR=2.38, 95% CI 2.03-2.79), and chorioamnionitis (OR=2.10, 95% CI 1.81-2.44). Conclusion. Epidural use, AROM, African-American ethnicity, nulliparity, and birth weight >4000g are associated with persistent OP position at delivery, with higher rates of operative deliveries and obstetric complications. This information can be useful in counseling patients regarding risks and associated outcomes of persistent OP position.

AB - Objective. To identify maternal and fetal risk factors associated with persistent occiput posterior position at delivery, and to examine the association of occiput posterior position with subsequent obstetric outcomes. Methods. This is a retrospective cohort study of 30 839 term, cephalic, singleton births. Women with persistent occiput posterior (OP) position at delivery were compared to those with occiput anterior (OA) position. Demographics, obstetric history, and labor management were evaluated and subsequent obstetric outcomes examined. Potential confounding variables were controlled for using multivariate logistic regression analysis. Results. The overall frequency of OP position was 8.3% in the study population. When compared to Caucasians, a higher rate of OP was observed among African-Americans (OR=1.4, 95% CI 1.25-1.64) while no other racial/ethnic differences were noted. Other associated factors included nulliparity, maternal age ≥35, gestational age ≥41 weeks, and birth weight >4000g, as well as artificial rupture of the membranes (AROM) and epidural anesthesia (p <0.001 for all). Persistent OP was associated with increased rates of operative vaginal (OR=4.14, 95% CI 3.57-4.81) and cesarean deliveries (OR=13.45, 95% CI 11.94-15.15) and other peripartum complications including third or fourth degree perineal lacerations (OR=2.38, 95% CI 2.03-2.79), and chorioamnionitis (OR=2.10, 95% CI 1.81-2.44). Conclusion. Epidural use, AROM, African-American ethnicity, nulliparity, and birth weight >4000g are associated with persistent OP position at delivery, with higher rates of operative deliveries and obstetric complications. This information can be useful in counseling patients regarding risks and associated outcomes of persistent OP position.

KW - Maternal outcome

KW - Persistent OP position

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