Labor length among overweight and obese women undergoing induction of labor

J Matern Fetal Neonatal Med. 2014 Nov;27(17):1771-5. doi: 10.3109/14767058.2013.879705. Epub 2014 Feb 3.

Abstract

Objective: Maternal weight is thought to impact labor. With rising rates of obesity and inductions, we sought to evaluate labor times among induced women by body mass index (BMI) category.

Methods: Retrospective cohort study of term inductions from 2005 to 2010. BMI categories were: normal weight (NW), overweight (OW), and obese (Ob) (18.5-24.9, 25-29.9, ≥30 kg/m(2)). Kruskal-Wallis tests compared median latent labor (LL) length and active labor (AL) length. Chi-square determined associations. Multivariable logistic regression controlled for confounders. Analyses were stratified by parity.

Results: A total of 448 inductions were analyzed. For nulliparas, there was no difference in LL by BMI category (p = 0.22). However, OW nulliparas had a longer AL compared to NW and Ob nulliparas (3.2, 1.7, 2.0 h, p = 0.005). For multiparas, NW had the shortest LL (5.5 h, p = 0.025) with no difference in AL among BMI categories (p = 0.42). The overall cesarean rate was 23% with no difference by BMI category (p = 0.95). However, Ob women had a greater percentage of first stage cesareans (41%) and NW had a greater percentage of second stage cesareans (55%), p = 0.06.

Conclusion: The association between BMI and labor length among inductions differs by phase of labor and parity. BMI also influences the stage of labor in which a cesarean occurs.

Keywords: Body mass index; induction of labor; labor curves; labor length; obesity.

MeSH terms

  • Adult
  • Body Mass Index
  • Body Weight / physiology
  • Female
  • Humans
  • Labor, Induced / statistics & numerical data*
  • Labor, Obstetric / physiology*
  • Obesity / epidemiology*
  • Overweight / epidemiology*
  • Parity
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Retrospective Studies
  • Time Factors
  • Young Adult