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RESULTS Prevalence of major LAM defects was 19.4% at six weeks and 10.4% at one year postpartum. No new major LAM defects were diagnosed at one year postpartum. Persisting major LAM defects were associated with longer second stage of labor (median 74.5 minutes versus median 48.0 minutes, p =0.012) and higher neonatal birthweight (mean difference of 232.3 grams, 95% CI 21.5-443.1). Vacuum delivery was independently associated with persistent major LAM defects, adjusted OR 3.0 (95% CI (1.0-9.. CONCLUSIONS There was a 50% reduction of so