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July 1, 2026International Journal of Gynecology & ObstetricsOpen Access

Severe maternal and neonatal morbidity or mortality in forceps versus cesarean birth in the second stage of labor: A systematic review and meta‐analysis

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Authors

IOIrina OlteanAKAbirami KirubarajanGMGiulia M. Muraca

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Overview

Systematic review compares severe maternal morbidity and neonatal outcomes between forceps and cesarean births, suggesting clinical considerations for each method.

Key Points

  • This study aims to compare severe maternal morbidity and neonatal morbidity or mortality following forceps and cesarean birth in the second stage of labor.
  • Four databases were searched until May 30, 2023, for original studies comparing SMM or SNMM among individuals with forceps birth versus cesarean birth.
  • Meta-analyses were conducted using the Mantel-Haenszel random-effects model and risk ratio (RR) for analysis.
  • Thirteen cohort studies with a total of 52,192 individuals were included in the analysis.
  • For severe maternal morbidity, the incidence was 2.6% for forceps versus 3.7% for cesarean with a pooled RR of 0.83 (95% CI 0.64, 1.07).
  • For neonatal morbidity or mortality, the incidence was 4.5% for forceps versus 2.1% for cesarean with a pooled RR of 1.34 (95% CI 0.90, 2.00).
  • The evidence regarding the risks of SMM and SNMM is very uncertain due to significant risk of bias and inconsistency.

Cite This Study

Oltean et al. (2026) studied this question.

synapsesocial.com/papers/6a44af325cd2549c8bc44453https://doi.org/10.1002/ijgo.71152
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Severe Neonatal Morbidity in Forceps versus Vacuum Birth among Individuals with Previous Cesarean Birth: A Population-Based Retrospective Cohort Study2025
  2. 2Maternal and neonatal outcomes of forceps delivery in women undergoing trial of labor after cesarean2026
  3. 3Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor2025
  4. 4Maternal morbidity following a trial of labor after cesarean birth: A scoping review of operative vaginal birth compared with cesarean birth in the second stage of labor2025
  5. 5A RETROSPECTIVE STUDY ON FETOMATERNAL OUTCOME IN SECOND STAGE CESAREAN-SECTION2024