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Am J Perinatol 2020; 37(04): 349-356
DOI: 10.1055/s-0039-1694982
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Maternal Obesity on Oxytocin Requirements to Achieve Vaginal Delivery

April D. Adams 
1   Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Women's and Infant Services, Washington, District of Columbia
,
Elizabeth M. Coviello
1   Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Women's and Infant Services, Washington, District of Columbia
,
Daphnie Drassinower
2   Division of Maternal-Fetal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia
› Author Affiliations
Funding None.
Further Information

Publication History

28 January 2019

09 July 2019

Publication Date:
20 August 2019 (online)

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Abstract

Objective Our objective was to determine if obese women are more likely to require oxytocin rates > 20 mU/min to achieve vaginal delivery, compared with normal weight women.

Study Design This is a retrospective cohort study of deliveries at the MedStar Washington Hospital Center and MedStar Georgetown University Hospital.

Results There were 4,284 births included in the analysis. Thirty-three per cent of deliveries were among women classified as overweight (body mass index [BMI] 25–29.9 kg/m2) and 58% were among women classified as obese (BMI >30.0 kg/m2), 12% were classified as class III obesity (BMI >40 kg/m2). Overall 110 (2.6%) women required an oxytocin rate of >20 mU/min. Doses of oxytocin >20 mU/min for women in the overweight, class I obesity, and class II obesity groups were 2.6, 1.9, and 1.6%, respectively. Deliveries among women with class III obesity had a significantly longer duration of oxytocin exposure (10.7 hours) compared with the normal weight group (8.2 hours, p < 0.001), and had a higher maximum rate of oxytocin compared (10 mU/min) to normal weight women (8 mU/min, p < 0.001).

Conclusion Obese women are more likely to require oxytocin rates more than 20 mU/min, higher doses of oxytocin, and greater duration of oxytocin exposure to achieve a vaginal delivery.

Keywords

obesity - oxytocin - labor induction - vaginal delivery

Note

The findings of this study were presented at the 38th Annual Pregnancy Meeting of the Society of Maternal-Fetal Medicine, January 29–February 3, 2018, Dallas, TX.