{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:25:13Z","timestamp":1785133513543,"version":"3.55.0"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>While use of augmentation of labor (AL) is appropriate for labor dystocia, it is frequently used inadequately and unnecessarily. The objective was to assess at a national level, the frequency and determinants of misuse of augmentation of labor (AL).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Material and methods<\/jats:title>\n<jats:p>Women of the French perinatal survey of 2016 with a singleton cephalic fetus, delivering at term after a spontaneous labor were included. \u201cMisuse of AL\u201d was defined by artificial rupture of the membranes (ROM) and\/or oxytocin within one hour of admission and\/or duration between ROM and oxytocin of less than one hour. Women, labor and maternity unit\u2019s characteristics were compared between the \u201cmisuse of AL\u201d and \u201cno misuse of AL\u201d groups by bivariate analysis. To identify the determinants of misuse of AL, a multivariable multilevel logistic regression was performed taking into account the data\u2019s hierarchical structure (first level: women, second level: maternity units).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 7196 women included, 1524 (21.2%) had a misuse of AL. The determinants of misuse of AL were middle school educational level (reference high school), aOR = 1.21; 95%CI[1.01\u20131.45], gestational age at delivery \u226541weeks (reference 39\u201340 weeks), aOR = 1.19; 95%CI[1.00\u20131.42], cervical dilation \u22656cm at admission (reference &lt;3cm), aOR = 1.39; 95%CI[1.10\u20131.76], epidural analgesia aOR = 1.63; 95%CI[1.35\u20131.96], delivery in a private hospital (reference public teaching hospital), aOR = 2.25; 95%CI[1.57\u20133.23]; and maternity units with &lt;1000 deliveries\/year and 1000\u20131999 deliveries\/year (reference \u22653000 deliveries\/year), respectively aOR = 1.52; 95%CI[1.11\u20132.08] and aOR = 1.42; 95%CI[1.05\u20131.92]. Less than 3% of the variance was explained by women characteristics, and 24.17% by the maternity units\u2019 characteristics.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In France, one spontaneous laboring woman among five is subject to misuse of AL. The misuse is mostly explained by maternity unit\u2019s characteristics. The determinants identified in this study can be used to implement targeted actions in small and private maternity units.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0246729","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:42:08Z","timestamp":1612917728000},"page":"e0246729","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Frequency and determinants of misuse of augmentation of labor in France: A population-based study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6101-1200","authenticated-orcid":true,"given":"Aude","family":"Girault","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Blondel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Le Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"pone.0246729.ref001","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.ogc.2017.08.012","article-title":"Augmentation of Labor: A Review of Oxytocin Augmentation and Active Management of Labor","volume":"44","author":"A Kernberg","year":"2017","journal-title":"Obstet Gynecol Clin North Am"},{"key":"pone.0246729.ref002","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1136\/bmj.2.5655.477","article-title":"Prevention of prolonged labour","volume":"2","author":"K O\u2019Driscoll","year":"1969","journal-title":"Br Med J"},{"key":"pone.0246729.ref003","article-title":"Package of care for active management in labour for reducing caesarean section rates in low-risk women","author":"HC Brown","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0246729.ref004","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/1477-7827-8-136","article-title":"Comparison between amniotomy, oxytocin or both for augmentation of labor in prolonged latent phase: a randomized controlled trial","volume":"8","author":"Z Nachum","year":"2010","journal-title":"Reprod Biol Endocrinol"},{"key":"pone.0246729.ref005","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1056\/NEJM199202133260705","article-title":"A controlled trial of a program for the active management of labor","volume":"326","author":"JA L\u00f3pez-Zeno","year":"1992","journal-title":"N Engl J Med"},{"key":"pone.0246729.ref006","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1056\/NEJM199509213331201","article-title":"A clinical trial of active management of labor","volume":"333","author":"FD Frigoletto","year":"1995","journal-title":"N Engl J Med"},{"key":"pone.0246729.ref007","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1056\/NEJM199304223281602","article-title":"Effect of early amniotomy on the risk of dystocia in nulliparous women. 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