We compared the duration of labor among nulliparous women with varying body mass index (BMI). Laboring nulliparous women at >37 weeks were included. First visit BMI was used to categorize weight as normal (≤24), overweight (25 to 29.9), or obese (≥30 kg/m(2)). Chi-square, one-way analysis of variance, and Bonferroni multiple comparisons tests were used. During 15 months, 375 women met the inclusion criteria, and 38% were obese. Duration of first stage of labor was significantly longer for obese versus normal-weight women (26.76 ± 0.77 versus 23.87 ± 0.66 hours; p = 0.024) but not between normal versus overweight women (p = 1.00) or overweight versus obese women (p = 0.114). The cesarean delivery rate was significantly different in the three groups (p = 0.0001), highest among obese (47%) and lowest in normal-weight women (24%). When adjusted for age, hypertension, and induction, the likelihood of completing stage I was significantly less among obese nulliparous than those with BMI < 24 kg/m(2) (hazard ratio 0.73, 95% confidence intervals 0.54, 0.99). Compared with those with BMI < 24, the duration of stage I is significantly longer among obese women, even when adjusted for maternal age, induction, and hypertension.

The racial/ethnic disparities in infant mortality in the United States persist and vary across GA. These disparities may largely be driven by the excess post-neonatal deaths among blacks.

Objective-To identify potentially modifiable risk factors of placental injury reflecting maternal uteroplacental vascular compromise (UPVC) and acute and chronic placental inflammation.Study design-A prospective epidemiologic study was conducted. A total of 1270 placentas were characterized by gross and microscopic examination. Placental pathology was coded for features of amniotic fluid infection syndrome (AFIS), chronic villitis, UPVC, and fetal vascular obstructive lesions. Odds ratios between UPVC, the acute and the chronic inflammatory lesions, and risk factors of interest were calculated.Results-After adjusting for confounders, women with a history of preterm birth had 1.60 times the odds of chronic inflammation (95% CI: 1.10, 2.55). Women with a previous elective termination had 3.28 times the odds of acute inflammation (95% CI: 1.89, 5.70). The odds of chronic villitis increased with parity, while the odds of AFIS decreased with parity.Conclusion-We have identified several predictors of UPVC, AFIS and chronic villitis. Further studies are needed to examine whether interventions to alter UPVC, AFIS and chronic villitis will lead to improved pregnancy outcomes.

Being within weight standards differs significantly for USMC and USN ADW after pregnancy.

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