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Abstract：
To evaluate the discrepancy between historical and more recent descriptions of the first stage of labour by testing whether the statistical techniques used recently (repeated-measures polynomial and interval-censored regression) were appropriate for detection of periods of rapid acceleration of cervical dilatation as might occur at the time of transition from a latent to an active phase of labour.
A simulation study using regression techniques.
We created a simulated data set for 500 000 labours with clearly defined latent and active phases using the parameters described by Friedman. Additionally, we created a data set comprising 500 000 labours with a progressively increasing rate of cervical dilatation.
Repeated-measures polynomial regression was used to create summary labour curves based on simulated cervical examinations. Interval-censored regression was used to create centimetre-by-centimetre estimates of rates of cervical dilatation and their 95th centiles.
Labour summary curves and rates of cervical dilatation.
Repeated-measures polynomial regression did not detect the rapid acceleration in cervical dilatation (i.e. acceleration phase) and overestimated lengths of labour, especially at smaller cervical dilatations. There was a two-fold overestimation in the mean rate of cervical dilatation from 4 to 6 cm. Interval-censored regression overestimated median transit times, at 4- to 5-cm cervical dilatation or when cervical examinations occurred less frequently than 0.5- to 1.5-hourly.
Repeated-measures polynomial regression and interval-censored regression should not be routinely used to define labour progress because they do not accurately reflect the underlying data.
Repeated-measures polynomial and interval-censored regression techniques are not appropriate to model first stage of labour.
A simulation study using regression techniques.
We created a simulated data set for 500 000 labours with clearly defined latent and active phases using the parameters described by Friedman. Additionally, we created a data set comprising 500 000 labours with a progressively increasing rate of cervical dilatation.
Repeated-measures polynomial regression was used to create summary labour curves based on simulated cervical examinations. Interval-censored regression was used to create centimetre-by-centimetre estimates of rates of cervical dilatation and their 95th centiles.
Labour summary curves and rates of cervical dilatation.
Repeated-measures polynomial regression did not detect the rapid acceleration in cervical dilatation (i.e. acceleration phase) and overestimated lengths of labour, especially at smaller cervical dilatations. There was a two-fold overestimation in the mean rate of cervical dilatation from 4 to 6 cm. Interval-censored regression overestimated median transit times, at 4- to 5-cm cervical dilatation or when cervical examinations occurred less frequently than 0.5- to 1.5-hourly.
Repeated-measures polynomial regression and interval-censored regression should not be routinely used to define labour progress because they do not accurately reflect the underlying data.
Repeated-measures polynomial and interval-censored regression techniques are not appropriate to model first stage of labour.
摘要：
通过测试最近使用的统计技术（重复测量多项式和间隔删失回归）是否适合检测宫颈扩张的快速加速时期来评估第一阶段的历史描述与最新描述之间的差异。从潜伏期过渡到活跃期。
使用回归技术的模拟研究。
我们使用Friedman描述的参数为500.000劳动力创建了一个模拟数据集，该数据集具有明确定义的潜在和活动阶段。此外,我们创建了一个数据集,该数据集包含50,000个劳动,宫颈扩张率逐渐增加.
根据模拟宫颈检查，使用重复测量多项式回归来创建总结产程曲线。间隔删失回归用于创建对宫颈扩张率及其第95百分位数的逐厘米估计。
产程总结曲线和宫颈扩张率。
重复测量多项式回归没有检测到宫颈扩张的快速加速（即加速阶段）和高估的产程长度，尤其是在较小的宫颈扩张时。宫颈扩张的平均速率从4到6cm高估了两倍。区间删失回归高估了过境时间中位数，在宫颈扩张4至5厘米或宫颈检查发生频率低于0.5至1.5小时时。
重复测量多项式回归和区间删失回归不应常规用于定义劳动进度，因为它们不能准确反映基础数据。
重复测量多项式和区间删失回归技术不适合对第一产程进行建模。
使用回归技术的模拟研究。
我们使用Friedman描述的参数为500.000劳动力创建了一个模拟数据集，该数据集具有明确定义的潜在和活动阶段。此外,我们创建了一个数据集,该数据集包含50,000个劳动,宫颈扩张率逐渐增加.
根据模拟宫颈检查，使用重复测量多项式回归来创建总结产程曲线。间隔删失回归用于创建对宫颈扩张率及其第95百分位数的逐厘米估计。
产程总结曲线和宫颈扩张率。
重复测量多项式回归没有检测到宫颈扩张的快速加速（即加速阶段）和高估的产程长度，尤其是在较小的宫颈扩张时。宫颈扩张的平均速率从4到6cm高估了两倍。区间删失回归高估了过境时间中位数，在宫颈扩张4至5厘米或宫颈检查发生频率低于0.5至1.5小时时。
重复测量多项式回归和区间删失回归不应常规用于定义劳动进度，因为它们不能准确反映基础数据。
重复测量多项式和区间删失回归技术不适合对第一产程进行建模。
