Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery
Abstract Introduction The etiology of lower‐limb neurological deficit after vaginal delivery remains poorly understood. The objective herein was to identify factors associated with this maternal nerve injury after vaginal delivery. Material and methods A single‐center, case–control (matching 1:4) st...
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| Format: | Article |
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Wiley
2023-01-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14441 |
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| author | Alexane Tournier Anne Cecile Doremieux Elodie Drumez Julien Labreuche François Cassim Max Gonzales Charles Garabedian Damien Subtil |
| author_facet | Alexane Tournier Anne Cecile Doremieux Elodie Drumez Julien Labreuche François Cassim Max Gonzales Charles Garabedian Damien Subtil |
| author_sort | Alexane Tournier |
| collection | DOAJ |
| description | Abstract Introduction The etiology of lower‐limb neurological deficit after vaginal delivery remains poorly understood. The objective herein was to identify factors associated with this maternal nerve injury after vaginal delivery. Material and methods A single‐center, case–control (matching 1:4) study. Cases were women with a lower‐limb neurological deficit that appeared immediately after vaginal delivery. Controls were randomly selected women who gave birth vaginally during the same period, without any deficit. Finally, to assess the rates of factors associated with these deficits, we studied them using a randomly selected 5% sample of the population with vaginal deliveries. Results During the 30‐month study period, 31 cases were identified among 10 333 women who gave birth vaginally (0.3%, 95% CI 0.20–0.43); 124 controls were also included. After logistic regression, the presence of a neurological deficit after delivery was associated with second‐stage labor duration (per hour odds ratio [OR] 3.67, 95% CI 2.09–6.44; OR per standard deviation increase 2.73, 95% CI 1.75–4.25, p < 0.001) and instrumental delivery (OR = 3.24, 95% CI 1.29–8.14, p = 0.012), with no interaction effect (p = 0.56). Extrapolation of these factors to a 5% sample of the overall population of women with vaginal births showed that the rate of these deficits would be very low for women with second‐stage labor lasting up to 90 min without instrumental delivery (0.05%) but increased to 1.52% when these factors were combined (OR 33.1, 95% CI 9.4–116.9). Conclusions Following vaginal delivery, the onset of a neurological deficit is principally associated with the duration of second‐stage labor and instrumental delivery. |
| format | Article |
| id | doaj-art-cda6b92d7dbd473994c43627ca142e2e |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-cda6b92d7dbd473994c43627ca142e2e2025-08-20T03:30:53ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-01-011021515810.1111/aogs.14441Factors associated with a maternal lower‐limb neurological deficit after vaginal deliveryAlexane Tournier0Anne Cecile Doremieux1Elodie Drumez2Julien Labreuche3François Cassim4Max Gonzales5Charles Garabedian6Damien Subtil7Women and Newborn Mother Unit Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceWomen and Newborn Mother Unit Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceEA 2694, METRICS, Evaluation of Health Technologies and Medical Practices Université Lille Lille FranceEA 2694, METRICS, Evaluation of Health Technologies and Medical Practices Université Lille Lille FranceNeuro‐sciences Unit, Clinical Neuro‐physiology Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceAnesthesia‐Resuscitation Unit Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceWomen and Newborn Mother Unit Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceWomen and Newborn Mother Unit Centre Hospitalier Universitaire de Lille, Université Lille Lille FranceAbstract Introduction The etiology of lower‐limb neurological deficit after vaginal delivery remains poorly understood. The objective herein was to identify factors associated with this maternal nerve injury after vaginal delivery. Material and methods A single‐center, case–control (matching 1:4) study. Cases were women with a lower‐limb neurological deficit that appeared immediately after vaginal delivery. Controls were randomly selected women who gave birth vaginally during the same period, without any deficit. Finally, to assess the rates of factors associated with these deficits, we studied them using a randomly selected 5% sample of the population with vaginal deliveries. Results During the 30‐month study period, 31 cases were identified among 10 333 women who gave birth vaginally (0.3%, 95% CI 0.20–0.43); 124 controls were also included. After logistic regression, the presence of a neurological deficit after delivery was associated with second‐stage labor duration (per hour odds ratio [OR] 3.67, 95% CI 2.09–6.44; OR per standard deviation increase 2.73, 95% CI 1.75–4.25, p < 0.001) and instrumental delivery (OR = 3.24, 95% CI 1.29–8.14, p = 0.012), with no interaction effect (p = 0.56). Extrapolation of these factors to a 5% sample of the overall population of women with vaginal births showed that the rate of these deficits would be very low for women with second‐stage labor lasting up to 90 min without instrumental delivery (0.05%) but increased to 1.52% when these factors were combined (OR 33.1, 95% CI 9.4–116.9). Conclusions Following vaginal delivery, the onset of a neurological deficit is principally associated with the duration of second‐stage labor and instrumental delivery.https://doi.org/10.1111/aogs.14441birthdeliverylower‐limb neurological deficitmaternal nerve injurysecond‐stage laborvaginal delivery |
| spellingShingle | Alexane Tournier Anne Cecile Doremieux Elodie Drumez Julien Labreuche François Cassim Max Gonzales Charles Garabedian Damien Subtil Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery Acta Obstetricia et Gynecologica Scandinavica birth delivery lower‐limb neurological deficit maternal nerve injury second‐stage labor vaginal delivery |
| title | Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery |
| title_full | Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery |
| title_fullStr | Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery |
| title_full_unstemmed | Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery |
| title_short | Factors associated with a maternal lower‐limb neurological deficit after vaginal delivery |
| title_sort | factors associated with a maternal lower limb neurological deficit after vaginal delivery |
| topic | birth delivery lower‐limb neurological deficit maternal nerve injury second‐stage labor vaginal delivery |
| url | https://doi.org/10.1111/aogs.14441 |
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