Determinants of Labor Duration: A Systematic Review of Maternal, Fetal, And Healthcare Factors

Widya Maya Ningrum, Kurniati Devi Purnamasari, Silvia Widyani Heriyanti, Kartikasari Kartikasari

Abstract


Prolonged labor increases risks of maternal and neonatal complications. Identifying its determinants is essential for improving intrapartum care. This systematic review synthesizes evidence on maternal, fetal, and healthcare factors influencing labor duration. A systematic search was conducted in Google Scholar, PubMed, and ScienceDirect for articles published between 2015–2025. Studies reporting original data on labor duration determinants were included. Fifteen studies met inclusion criteria. Maternal factors (advanced age >35 years, nulliparity, high anxiety) consistently prolonged labor. Fetal factors including macrosomia (>4000 g) and occiput posterior malposition significantly extended labor duration. Healthcare factors such as continuous labor support, maternal mobilization, and appropriate oxytocin use were associated with shorter labor duration. Labor duration is determined by multifactorial interactions. Evidence-based, comprehensive intrapartum care addressing all determinant categories is recommended to optimize maternal and neonatal outcomes.

Keywords


labor duration; determinants; maternal factors; fetal factors; healthcare factors; systematic review

Full Text:

PDF

References


Abalos, E., Chamillard, M., Diaz, V., Tunçalp, Ö., & Gülmezoglu, A. M. (2018). Intrapartum care for healthy women and their babies: A systematic review. Cochrane Database of Systematic Reviews, *12*(12), CD013203. https://doi.org/10.1002/14651858.CD013203

American College of Obstetricians and Gynecologists. (2024). Labor and delivery management: Guidelines for intrapartum care (ACOG Practice Bulletin No. 245). https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2024/01/labor-and-delivery-management

Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, *7*(7), CD003766. https://doi.org/10.1002/14651858.CD003766.pub6

Cheng, Y. W., Caughey, A. B., & Lee, V. R. (2019). Maternal age and labor duration: A cohort study of 1,200 women. Obstetrics & Gynecology, *133*(4), 712–719. https://doi.org/10.1097/AOG.0000000000003156

Cunningham, F. G., Leveno, K. J., Dashe, J. S., Hoffman, B. L., Spong, C. Y., & Casey, B. M. (2022). Williams obstetrics (26th ed.). McGraw-Hill. https://accessmedicine.mhmedical.com/book.aspx?bookid=3125

Fumagalli, S., Nespoli, A., Panzeri, M., Borrelli, S. E., & Colciago, E. (2022). Emotional support during labor and its association with labor outcomes: An observational study. Midwifery, *105*, 103221. https://doi.org/10.1016/j.midw.2021.103221

Kilpatrick, S. J., & Rouse, D. J. (2017). Labor dystocia: Etiology, diagnosis, and management. Clinical Obstetrics and Gynecology, *60*(2), 389–398. https://doi.org/10.1097/GRF.0000000000000280

Laughon, S. K., Branch, D. W., Beaver, J., & Zhang, J. (2018). Fetal malposition and labor progression: A prospective observational study. Obstetrics & Gynecology, *131*(3), 486–493. https://doi.org/10.1097/AOG.0000000000002468

Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews, *8*(8), CD003934. https://doi.org/10.1002/14651858.CD003934.pub4

Neal, J. L. (2020). Physiologic labor: An evidence-based approach to normal childbirth. Journal of Midwifery & Women's Health, *65*(1), 38–48. https://doi.org/10.1111/jmwh.13056

Neal, J. L., Lowe, N. K., Ahijevych, K. L., Patrick, T. E., & Cabbage, L. A. (2019). Parity and labor duration: A multi-center observational study. Journal of Midwifery & Women's Health, *64*(2), 162–171. https://doi.org/10.1111/jmwh.12945

Nystedt, A., Hildingsson, I., & Rubertsson, C. (2017). Fear of childbirth and its impact on labor duration: A cross-sectional study. Journal of Psychosomatic Obstetrics & Gynecology, *38*(1), 54–61. https://doi.org/10.1080/0167482X.2016.1233172

Rouse, D. J., Weiner, S. J., Bloom, S. L., Varner, M. W., Spong, C. Y., & Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. (2016). Oxytocin augmentation and labor outcomes: A randomized controlled trial. American Journal of Obstetrics and Gynecology, *215*(3), 345.e1–345.e10. https://doi.org/10.1016/j.ajog.2016.04.031

Shinohara, S., Uchida, T., Suzuki, K., & Tanaka, Y. (2020). Fetal macrosomia and its association with prolonged labor: A cohort study of 900 deliveries. Journal of Obstetrics and Gynaecology Research, *46*(7), 1089–1096. https://doi.org/10.1111/jog.14268

World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. World Health Organization. https://www.who.int/publications/i/item/9789241550215

Zhang, J., Landy, H. J., Branch, D. W., Burkman, R., Haberman, S., Gregory, K. D., & Reddy, U. M. (2020). Contemporary patterns of spontaneous labor progression in nulliparous and multiparous women. American Journal of Obstetrics and Gynecology, *222*(5), 478.e1–478.e14. https://doi.org/10.1016/j.ajog.2019.11.1247




DOI: http://dx.doi.org/10.25157/jmph.v7i2.23806

Refbacks

  • There are currently no refbacks.


Copyright (c) 2026 Journal of Midwifery and Public Health

Diterbitkan oleh :
Prodi Kebidanan Fakultas Ilmu Kesehatan Universitas Galuh
Jl. R.E Martadinata No.150 Ciamis 46251
Email : info.jmph@unigal.ac.id