Effects of Free Position in the Labor on Maternal and Neonatal Birth Outcomes:A Meta-analysis
XIAO Qing-qing
GAO Jing
LI Xing
YU Jing-ya
GUO Xiao-xiao
LIU Jie
Abstract：Objective: To evaluate the effect of free position during labor on maternal and neonatal outcomes on primipara. Methods:We searched the PubMed, Embase, CENTRAL, Web of Science, CINAHL, CBM, CNKI, VIP, WanFang Data from inception to April, 2017, to collect the randomized controlled trials (RCTs) in which the use of the free position during the labor on primipara. Two reviewers independently selected and included literatures according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was conducted by RevMan 5.3 software. Results: A total of 18 RCTs involving 3603 patients were included. Meta-analysis showed that duration of labor (MD=-2.98, 95%CI: -3.29~-2.68, P<0.00001), caesarean section rate (RR=0.43, 95%CI: 0.37~0.51, P<0.00001), postpartum hemorrhage rate (RR=0.25, 95%CI:0.15~0.40, P<0.00001), the rate of third degree laceration of perineum (RR=0.33, 95%CI:0.17~0.67, P=0.002), cervical laceration rate (RR=0.34, 95%CI:0.21~0.55, P<0.00001), neonatal asphyxia rate (RR=0.31, 95%CI:0.21~0.47, P<0.00001), neonatal intracranial hemorrhage rate (RR=0.22, 95%CI:0.08~0.57, P=0.002) in the free position group were significantly lower than those in the conventional supine position group. There were no significant differences on the incidence of neonatal aspiration syndrome (RR=0.73, 95%CI:0.30~1.80, P=0.50) in two groups of the study. Conclusions:Current evidence shows that, comparing to conventional supine position, free position on primipara can shorten duration of labor, and promote spontaneous labor, reduce the caesarean section, postpartum hemorrhage, laceration of birth canal, neonatal asphyxia, and neonatal intracranial hemorrhage, moreover, not increase postpartum hemorrhage. However, because limitation of quality of included studies, more high-quality studies are needed to confirm the above conclusion.
Keywords：ParityParturitionMeta-analysisPrimiparaFree position
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 552-559,564 )