The Effect of Maternal Position on Maternal, Fetal and Neonatal Outcomes: A Systematic Review

Background aim: Maternal care during the different stages of labor should be targeted towards the promotion of maternal, fetal, and neonatal health status. Maternal position is very important in labour and delivery Care. Nevertheless, there is controversial results regarding the effect of maternal position in labor. The present study reviewed the effect of maternal position on maternal, fetal, and neonatal outcomes.      Methods: In this systematic review, databases including PubMed, Web of Science, Scopus, Google Scholar as well as Persian databases of Magiran and SID, were searched and all related articles between 2005 to 2018 were retrieved. The quality of the studies was examined using the Joanna Briggs Institute tool. Results: 17 clinical trials performed on 4,848 subjects were reviewed. Maternal position during the labour were the upright and lying positions. The outcome measures included duration of the different stages of labor, persistent posterior position, postpartum hemorrhage, maternal pain, anxiety and fatigue. The fetal and neonatal outcomes entailed Apgar score, umbilical venous blood pH, need for neonatal resuscitation, and need for hospitalization in NICU. The results revealed that different maternal positions during the first and second-stage of labor did not affect maternal, fetal, and neonatal outcomes. However, all studies stated that lowrisk mothers should have the chance for choosing a comfortable position in the different stages of labor. Conclusion: In order to propose an evidencebased care plan concerning maternal position in labor, it is required to perform further studies with higher quality regarding the effect of maternal position on maternal, fetal, and neonatal outcomes.