Frequency and determinants of misuse of augmentation of labor in France: A population-based study

• DOI: 10.1371/journal.pone.0246729
• Publication Date: 2021-02-10T00:42:08Z
• Authors: Aude Girault; Béatrice Blondel; François Goffinet; Camille Le Ray
• Keywords: Cervical dilation; Singleton

Introduction While use of augmentation labor (AL) is appropriate for dystocia, it frequently used inadequately and unnecessarily. The objective was to assess at a national level, the frequency determinants misuse (AL). Material methods Women French perinatal survey 2016 with singleton cephalic fetus, delivering term after spontaneous were included. “Misuse AL” defined by artificial rupture membranes (ROM) and/or oxytocin within one hour admission duration between ROM less than hour. Women, maternity unit’s characteristics compared “misuse “no groups bivariate analysis. To identify AL, multivariable multilevel logistic regression performed taking into account data’s hierarchical structure (first level: women, second units). Results Among 7196 women included, 1524 (21.2%) had AL. AL middle school educational level (reference high school), aOR = 1.21; 95%CI[1.01–1.45], gestational age delivery ≥41weeks 39–40 weeks), 1.19; 95%CI[1.00–1.42], cervical dilation ≥6cm <3cm), 1.39; 95%CI[1.10–1.76], epidural analgesia 1.63; 95%CI[1.35–1.96], in private hospital public teaching hospital), 2.25; 95%CI[1.57–3.23]; units <1000 deliveries/year 1000–1999 ≥3000 deliveries/year), respectively 1.52; 95%CI[1.11–2.08] 1.42; 95%CI[1.05–1.92]. Less 3% variance explained characteristics, 24.17% units’ characteristics. Conclusions In France, laboring woman among five subject mostly identified this study can be implement targeted actions small units.