Neonatal outcomes associated with obstetric interventions performed during labor in nulliparous women




Infant, Newborn; Obstetric Nursing; Labor, Obstetric.


Objective: to analyze neonatal outcomes associated with obstetric interventions performed during labor in low-risk nulliparous women. Methods: a cross-sectional observational study of 534 low-risk nulliparous women. Results: interruption of skin-to-skin contact after delivery was shown to be associated with obstetric interventions such as cardiotocography at admission, oxytocin in labor, amniotomy, and episiotomy. The need for positive pressure ventilation and oxygen therapy was associated with the encouragement of the Valsalva maneuver; the performance of this maneuver was also associated with interventions such as amniotomy, episiotomy and directed pulling. Conclusion: the study showed that the use of obstetric interventions during labor in low-risk women is associated with unfavorable neonatal outcomes that lead to the need for further interventions after delivery.


Melo BM, Gomes LFS, Henriques ACPT, Lima SKM, Damasceno AKC. Implementation of good practice in assistance to labor at a reference maternity. Rev Rene. 2017; 18(3):376-82. doi:

Pereira SB, Diaz CMG, Backes MTS, Ferreira CLL, Backes DS. Good practices of labor and birth care from the perspective of health professionals. Rev Bras Enferm. 2018; 71(Suppl 3):1313-9. doi:

World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience [Internet]. 2018 [cited Jan 15, 2021]. Available from:

Cortês CT, Oliveira SMJV, Santos RCS, Francisco AA, Riesco MLG, Shimoda GT. Implementation of evidence-based practices in normal delivery care. Rev Latino-Am Enfermagem. 2018; 26:e2988. doi:

França EB, Lansky S, Rego MAS, Malta DC, França JS, Teixeira R, et al. Leading causes of child mortality in Brazil, in 1990 and 2015: estimates from the Global Burden of Disease study. Rev Bras Epidemiol. 2017; 20(Suppl 1):46-60. doi:

Leal MC, Szwarcwald CL, Almeida PVB, Aquino EML, Barreto ML, Barros F, et al. Reproductive, maternal, neonatal and child health in the 30 years since the creation of the Unified Health System (SUS). Ciênc Saúde Coletiva. 2018; 23(6):1915-28. doi:

Teixeira JAM, Araujo WRM, Maranhão AGK, Cortez-Escalante JJ, Rezende LFM, Matijasevich A. Mortality on the first day of life: trends, causes of death and avoidability in eight Brazilian Federative Units, between 2010 and 2015. Epidemiol Serv Saúde. 2019; 28(1):e2018132. doi:

Velho MB, Brüggemann OM, McCourt C, Gama SGN, Knobel R, Gonçalves AC, et al. Obstetric care models in the Southern Region of Brazil and associated factors. Cad Saúde Pública. 2019; 35(3):e00093118. doi:

Silva YAP, Araújo FG, Amorim T, Martins EF, Felisbino-Mendes MS. Obstetric analgesia in labor and its association with neonatal outcomes. Rev Bras Enferm. 2020; 73(2):e20180757. doi:

Prado DS, Mendes RB, Gurgel RQ, Barreto IDC, Bezerra FD, Cipolotti R, et al. Practices and obstetric interventions in women from a state in the Northeast of Brazil. Rev Assoc Med Bras. 2017; 63(12):1039-48. doi:

Gu C, Wang X, Zhang Z, Schwank S, Zhu C, Zhang Z, et al. Pregnant women’s clinical characteristics, intrapartum interventions, and duration of labour in urban China: a multi-center cross-sectional study. BMC Pregnancy Childbirth. 2020; 20(1):386. doi:

Moore ER, Bergman N, Anderson GC, Medley N. Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016; 11(11):CD003519. doi:

Bayes S, Whitehead L. Cardiotocography vs. Intermittent auscultation in assessing fetal well-being. Am J Nurs. 2018; 118(6):23. doi:

Thellesen L, Bergholt T, Sorensen JL, Rosthoej S, Hvidman L, Eskenazi B, et al. The impact of a national cardiotocography education program on neonatal and maternal outcomes: a historical cohort study. Acta Obstet Gynecol Scand. 2019; 98(10):1258-67. doi:

Leal MC, Bittencourt SA, Esteves-Pereira AP, Silva Ayres BV, Silva LBRAA, Thomaz EBAF, et al. Progress in childbirth care in Brazil: preliminary results of two evaluation studies. Cad Saúde Pública. 2019; 35(7):e00223018. doi:

Shmueli A, Gabbay Benziv R, Hiersch L, Ashwal E, Aviram R, Yogev Y, et al. Episiotomy–risk factors and outcomes. J Matern Fetal Neonatal Med. 2017; 30(3):251-56. doi:

Chen HY, Blackwell SC, Chauhan SP. Association between apgar score at 5 minutes and adverse outcomes among Low-Risk pregnancies. J Matern Fetal Neonatal Med. 2020; 16:1-8. doi:

Vaziri F, Arzhe A, Asadi N, Pourahmad S, Moshfeghy Z. Spontaneous pushing in lateral position versus valsalva maneuver during second stage of labor on maternal and fetal outcomes: a randomized clinical trial. Iran Red Crescent Med J. 2016; 18(10):e29279. doi:

Battarbee AN, Glover AV, Stamilio DM. Association between early amniotomy in labour induction and severe maternal and neonatal morbidity. Aust N Z J Obstet Gynaecol 2019; 60(1):1-7. doi:

Sandström A, Altman M, Cnattingius S, Johansson S, Ahlberg M, Stephansson O. Durations of second stage of labor and pushing, and adverse neonatal outcomes: a population-based cohort study. J Perinatol. 2017; 37(3):236-42. doi:



How to Cite

Monteiro, P. G. A., Coelho, T. da S., Lima, A. M. de, Ferreira, U. R., Monteiro, M. S. B., Esteche, C. M. G. da C. E., & Damasceno, A. K. de C. (2021). Neonatal outcomes associated with obstetric interventions performed during labor in nulliparous women. Rev Rene, 22, e67921.



Research Article

Most read articles by the same author(s)

1 2 3 > >>