Obesity decreases the chance to deliver spontaneously
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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
- 1.WHO (2010) Global database on body mass index. WHO Publishing web. http://apps.who.int/bmi/index. Accessed 14 Feb 2010
- 2.Branca F (2006) Ten things you need to know about obesity. WHO Europe Publishing web. http://www.euro.who.int/obesity. Accessed 22 Aug 2006
- 6.Beers M, Berkow R (2000) MSD manual, 6th edn. Urban und Fischer, München, pp 68–72Google Scholar
- 7.Aagard-Tillery A, Flint Porter T, Malone F, Nyberg D, Collins J, Comstock C, Hankins G, Eddlemann K, Dugoff L, Wolfe H, Alton M (2010) Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn 30:14–22Google Scholar
- 8.Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, Saade G, Eddleman K, Carter SM, Craigo SD, Carr SR, D’Alton ME, FASTER Research Consortium (2004) Obesity, obstetric complications and cesarean delivery rate—a population-based screening study. Am J Obstet Gynecol 190:1091–1097PubMedCrossRefGoogle Scholar
- 12.Wittner FR, Caufield LE, Stoltzfus RJ (1995) Influence of maternal anthropometric status and birth weight on the risk of cesarian delivery. Obstet Gynecol 167:958–962Google Scholar
- 13.Ben-Haroush A, Hadar E, Chen R, Hod M, Yogev Y (2009) Maternal Obesity is a major risk factor for large- for- gestational- infants in pregnancies complicated by gestational diabetes. ArchGynecolObstet 209:539–543Google Scholar
- 14.Miettinen OS (1974) Simple interval estimation of risk ratio. Am J Epidemiol 100:515–516 (letter)Google Scholar
- 17.Langenveld J, Jansen S, van der Post J, Wolf H, Mol BW, Ganzevoort W (2010) Recurrence risk of a delivery before 34 weeks of pregnancy due to an early onset hypertensive disorder: a systematic review. Am J Perinatol. doi:10.1055/s-0030-1248944