Obesity decreases the chance to deliver spontaneously
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- Beyer, D.A., Amari, F., Lüdders, D.W. et al. Arch Gynecol Obstet (2011) 283: 981. doi:10.1007/s00404-010-1502-5
To evaluate the impact of maternal obesity on labour, intrapartual assessment and delivery.
Retrospective cohort analysis of n = 11,681 deliveries supervised between 01 January 2000 and 31 December 2009. Results were analysed dividing the patients into two main groups according to their body mass index (BMI): group 1, control: BMI 18–24.9 and group 2 BMI, test >25. Subgroups were built: (0) BMI 25–29.9, (I) BMI 30–34.9, (II) BMI 35–39.9, (III) BMI >40. Exclusion criteria were defined as: delivery <37 + 0 weeks p.m., multiple pregnancy, comorbidity other than GDM, abnormal presentation, BMI <18.5, and incomplete data. The main outcome parameter was defined as secondary caesarean delivery rate and mode of delivery.
N = 8,379 patients met the inclusion criteria and were divided in two groups: 1, n = 4,464 patients and 2, n = 3,915. Basic maternal characteristics including foetal vital parameters were equal in all groups. GDM occurred more frequently in obese patients (P < 0.001). For the main outcome parameter a significant decrease in the rate of spontaneous delivery between control/test groups (72–66%, P < 0.001) and control/I–III groups (72 vs. 50%, P < 0.001) could be observed. The rate of secondary c-section increased significantly according to a higher BMI (>40: OR 2.5, 95% CI 1.84–3.61, χ2P < 0.001). The groups showed no difference in the rate of injuries during delivery though foetal birth weight increased significantly with a higher BMI (3,412–3,681 g; P < 0.001).
Obesity decreases the chance to deliver spontaneously. Moreover, the obese patient suffers from a significantly longer trial of labour (7.9 vs. 9.5 h) and an elevated risk of surgical delivery.
KeywordsObesity Labour Mode of delivery Maternal injury Foetal outcome
Body mass index
Relative risk reduction
Gestational diabetes mellitus