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Am J Perinatol 2018; 35(01): 059-064
DOI: 10.1055/s-0037-1605574
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Spontaneous Labor Onset and Outcomes in Obese Women at Term

Antonina I. Frolova
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Judy J. Wang
2   The Ohio State University College of Medicine, Columbus, Ohio
,
Shayna N. Conner
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Methodius G. Tuuli
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
George A. Macones
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Candice L. Woolfolk
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
,
Alison G. Cahill
1   Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri
› Author Affiliations
Further Information

Publication History

09 June 2017

10 July 2017

Publication Date:
11 August 2017 (online)

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Abstract

Objective The objective of this study was to compare the rates of spontaneous labor onset and its progression in obese and nonobese women after 37 weeks.

Study Design We performed a secondary analysis of a retrospective cohort of all women who were admitted for delivery at ≥ 37 weeks of gestation at a university-based tertiary care center between 2004 and 2010. The cohort was stratified by weeks of gestation at which the patient presented for delivery. The rates of spontaneous labor, vaginal delivery, and augmentation with oxytocin were compared between obese (body mass index [BMI] ≥ 30) and nonobese (BMI < 30) women.

Results Obese women had lower rates of spontaneous labor than nonobese women at every gestational week (37 weeks, 6.1 vs. 9.3%, p < 0.001; 38 weeks, 12.8 vs. 19.2%, p < 0.001; 39 weeks 26.0 vs. 37.0%, p < 0.001; 40 weeks, 39.6 vs. 50.2%, p < 0.001; 41 weeks, 30.8 vs. 38.0%, p < 0.012). Among women who presented in spontaneous labor, obesity was associated with higher rates of augmentation with oxytocin and lower rates of vaginal delivery.

Conclusion Obese women at or beyond 37 weeks are less likely to experience spontaneous labor compared with nonobese women. In addition, obese women presenting in spontaneous labor are less likely that nonobese women to have a vaginal delivery at 37 to 40 weeks, even after oxytocin augmentation.

Keywords

obesity - spontaneous labor - labor augmentation - parturition

Condensation

Obese women are less likely to experience spontaneous labor and vaginal delivery after 37 weeks compared with nonobese women.


Funding

Dr. Cahill is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061619–01, PI Cahill) which partially supported this work.


 

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