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CC BY-NC-ND 4.0 · AJP Rep 2021; 11(02): e105-e112
DOI: 10.1055/s-0041-1732409
Original Article

Association between Maternal Obesity Class, Adherence to Labor Guidelines, and Perinatal Outcomes

Irene A. Stafford
1   Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, Texas
,
Ahmed S.Z. Moustafa
2   Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, Flint, Michigan
,
Lauren Spoo
3   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
Alexandra Berra
3   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
Angela Burgess
1   Department of Obstetrics and Gynecology, University of Texas Health Science Center, Houston, Texas
,
Mark Turrentine
3   Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
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Abstract

Background Data are limited concerning rates of perinatal complications in women with a body mass index (BMI) ≥40 kg/m2 compared to women with other BMI classes when guidelines for the safe prevention of the primary cesarean delivery are applied.

Objective The aim of the study is to evaluate labor guideline adherence by BMI class and to compare perinatal outcomes across BMI classes with guideline adherent management.

Study Design This retrospective study included low-risk women admitted for delivery between April 2014 and April 2017 after the labor guidelines were implemented. BMI closest to delivery was used for analysis. Women with cesarean for nonreassuring fetal status were excluded.

Results Guideline adherence decreased with increasing BMI, with 93% adherence among women of normal weight compared to 81% for class III obese women (p < 0.0001). Among women who had guideline-adherent management, there was increased rates of cesarean among class III versus other obesity classes; however, there were no differences in rates of infectious morbidity (p = 0.98) or hemorrhage (p = 0.93). Although newborns of women with class III obesity had higher rates of meconium at birth, neonatal outcomes were not different with increasing maternal BMI (p = 0.65).

Conclusion There were no differences in adverse perinatal outcomes with increasing BMI.

Keywords

overweight - obesity - labor dystocia - primary cesarean guidelines

Note

IRB approval: H-26364.


This work has not been published previously and is not under consideration for publication elsewhere.




Publication History

Received: 12 January 2020

Accepted: 06 April 2020

Article published online:
15 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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