New labor management and obstetric outcomes: A systematic review and meta-analysis
Bibliographic record
Abstract
Objective: This systematic review and meta-analysis is to compare the new labor management guideline with the traditional WHO guideline with regard to obstetric outcomes. Methods: The literature search was performed in the following databases: PubMed, Embase, Web of Science, the Cochrane Library and Chinese databases (including CNKI, WanFang Database and VIP). Randomized controlled trials (RCTs) or cohort studies comparing the new labor management and the old WHO guideline in terms of maternal and neonatal morbidity in low-risk pregnant women were included. Study quality was assessed using the Cochrane Risk Bias Evaluation Tool and Newcastle-Ottawa Scale (NOS). The I2 statistic was used to evaluate heterogeneity. We used the random-effects model to pool the relative risk (RR) with corresponding 95% confidence intervals (CI). Prespecified subgroup and sensitivity analyses were conducted to explore the potential influencing factors. Publication bias analysis was also assessed based on funnel plots. Results: A total of 45 studies with a total sample size of 82,016 women were eventually included, with 15 RCTs and 30 cohort studies. 44 studies were included for data synthesis. Women with new labor management had less labor augmentation with oxytocin (RCTs: RR = 0.55 [0.36, 0.83], I2 = 47%; cohort studies: RR = 0.62 [0.55, 0.70], I2 = 58%), intrapartum cesarean section (RCTs: RR = 0.52 [0.47, 0.59], I2 = 0; cohort studies: RR = 0.61 [0.55, 0.67], I2= 75%) and operative vaginal delivery (RCTs: RR = 0.60 [0.42, 0.87], I2 = 0; cohort studies: RR = 0.69 [0.55, 0.86], I2 = 82%) without increasing the incidence of 3rd- and 4th-degree perineal laceration, postpartum hemorrhage, infectious morbidity and postpartum urine retention, fetal distress, neonatal asphyxia or neonatal intensive care unit (NICU) admission. These results were robust to sensitivity analyses. Conclusion: Our study indicates that the new labor management guideline may be more beneficial than the traditional WHO guideline, with fewer intrapartum interventions and no increase in adverse obstetric outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.052 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.042 |
| Bibliometrics | 0.010 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".