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Arrowsmith, Sarah; Wray, Susan; Quenby, Siobhan (2011)
Publisher: Wiley-Blackwell Publishing Ltd.
Languages: English
Types: Article
Subjects: RC, RG
Objective: To investigate the effect of maternal obesity on mode of delivery following induction of labour (IOL) for prolonged pregnancy and subsequent intrapartum and neonatal complications. \ud Design: Retrospective (historical) cohort study. \ud Setting: Liverpool Women's Hospital NHS Foundation Trust, UK. \ud Population: A total of 29,224 women with singleton pregnancies between 2004 and 2008 of whom 3076 had a prolonged pregnancy (defined as >= 290 days or 41(+3) weeks of gestation) and received IOL. \ud \ud Methods: Kruskal-Wallis test, chi-square test and multivariable logistic regression. \ud \ud Main outcome measures: Mode of delivery and risk of delivery and neonatal complications in obese verses non-obese women following IOL. \ud \ud Results: Obese women had a significantly higher rate of IOL ending in caesarean section compared with women of normal weight following IOL (38.7% versus 23.8% primiparous; 9.9% versus 7.9% multiparous women, respectively); however, length of labour, incidence of postpartum haemorrhage and third-degree tear, rate of low cord blood pH, low Apgar scores and shoulder dystocia were similar in all body mass index categories. Complications included a higher incidence of fetal macrosomia and second-degree, but not third-degree, tear in primiparous women. \ud \ud Conclusions: Higher maternal body mass index at booking is associated with an increased risk of prolonged pregnancy and increased rate of IOL. Despite this, more than 60% of obese primiparous and 90% of multiparous women with prolonged pregnancies who were induced achieved vaginal delivery and labour complications in the obese women with prolonged pregnancies were largely comparable to those of normal weight women with prolonged pregnancies. Our data suggest that IOL for prolonged pregnancy in obese women is a reasonable and safe management option.
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    • 1 World Health Organisation. Fact sheet: obesity and overweight. [www.who.int/mediacentre/factsheets/fs311/en/index.html]. Last accessed 30 October 2009.
    • 2 Ramsay JE, Greer I, Sattar N. ABC of obesity. Obesity and reproduction. BMJ 2006;333:1159-62.
    • 3 Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008;9:635-83.
    • 4 Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989- 2007. Int J Obes (Lond) 2010;34:420-8.
    • 5 Kanagalingam MG, Forouhi NG, Greer IA, Sattar N. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. BJOG 2005;112:1431-3.
    • 6 Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004;103:219-24.
    • 7 Zhang J, Bricker L, Wray S, Quenby S. Poor uterine contractility in obese women. BJOG 2007;114:343-8.
    • 8 Johnson JW, Longmate JA, Frentzen B. Excessive maternal weight and pregnancy outcome. Am J Obstet Gynecol 1992;167:353-70; discussion 70-2.
    • 9 Nohr EA, Bech BH, Davies MJ, Frydenberg M, Henriksen TB, Olsen J. Prepregnancy obesity and fetal death: a study within the Danish National Birth Cohort. Obstet Gynecol 2005;106:250-9.
    • 10 Denison FC, Price J, Graham C, Wild S, Liston WA. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG 2008;115:720-5.
    • 11 Stotland NE, Washington AE, Caughey AB. Prepregnancy body mass index and the length of gestation at term. Am J Obstet Gynecol 2007;197:378 e1-5.
    • 12 Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AM. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol 2004;104: 943-51.
    • 13 Khashan AS, Kenny LC. The effects of maternal body mass index on pregnancy outcome. Eur J Epidemiol 2009;24:697-705.
    • 14 Caughey AB, Stotland NE, Washington AE, Escobar GJ. Who is at risk for prolonged and postterm pregnancy? Am J Obstet Gynecol 2009;200:683 e1-5.
    • 15 Graves BW, DeJoy SA, Heath A, Pekow P. Maternal body mass index, delivery route, and induction of labor in a midwifery caseload. J Midwifery Womens Health 2006;51:254-9.
    • 16 Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 2001;25: 1175-82.
    • 17 Usha Kiran TS, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG 2005;112: 768-72.
    • 18 Olesen AW, Westergaard JG, Olsen J. Perinatal and maternal complications related to postterm delivery: a national register-based study, 1978-1993. Am J Obstet Gynecol 2003;189:222-7.
    • 19 Caughey AB, Stotland NE, Washington AE, Escobar GJ. Maternal and obstetric complications of pregnancy are associated with increasing gestational age at term. Am J Obstet Gynecol 2007;196: 155.e1-6.
    • 20 Caughey AB, Snegovskikh VV, Norwitz ER. Postterm pregnancy: how can we improve outcomes? Obstet Gynecol Surv 2008;63:715- 24.
    • 21 NICE antenatal care clinical guideline March 2008. [http://guidance. nice.org.uk/CG62]. Last accessed 30 October 2009.
    • 22 Driul L, Cacciaguerra G, Citossi A, Martina MD, Peressini L, Marchesoni D. Prepregnancy body mass index and adverse pregnancy outcomes. Arch Gynecol Obstet 2008;278:23-6.
    • 23 Bhattacharya S, Campbell DM, Liston WA. Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007;7:168.
    • 24 Smith GC, Shah I, Pell JP, Crossley JA, Dobbie R. Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study. Am J Public Health 2007;97:157- 62.
    • 25 Mahmood TA, Campbell DM, Wilson AW. Maternal height, shoe size, and outcome of labour in white primigravidas: a prospective anthropometric study. BMJ 1988;297:515-7.
    • 26 Caughey AB, Nicholson JM, Cheng YW, Lyell DJ, Washington AE. Induction of labor and cesarean delivery by gestational age. Am J Obstet Gynecol 2006;195:700-5.
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