Effect of maternal obesity on labor induction in postdate pregnancy

Maged, Ahmed M.; Elsemary, Ali; Marie, Heba; Belal, Doaa S.; Hany, Ayman; Taymour, Mohammad A.; Omran, Eman; Elbaradie, Sahar M Y; Mohamed, Mohamed A. Kamal

doi:10.1007/s00404-018-4767-8

Cited by 27 publications

(23 citation statements)

References 18 publications

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“…They are less likely to have spontaneous labour and tend to have postterm pregnancy, as shown in previous studies [39,40]. In addition to the increased frequency of obstetric morbidities, such as GDM and hypertensive disorders among obese women which is directly associated with the increased need of IOL, moreover, they are more likely to experience failure of IOL and an increased risk of CS delivery compared to normal weight women [41,42]. This may be explained by the abnormal uterine contractions and dysfunctional labour noticed among obese women [43].…”

Section: Discussionmentioning

confidence: 72%

Maternal Prepregnancy Weight and Pregnancy Outcomes in Saudi Women: Subgroup Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

Wahabi

Esmaeil

Fayed

2021

BioMed Research International

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The objectives of this study were to estimate the prevalence of prepregnancy overweight/obesity and underweight among Saudi mothers and to determine the adverse pregnancy outcomes associated with them. Methods. This is a subgroup analysis from a Riyadh mother and baby cohort study. Participants were divided into four groups according to prepregnancy BMI. Participants with normal BMI were the reference group. Groups were compared in relation to pregnancy-related obstetric, as well as fetal and neonatal complications. A regression model was used to control for covariates, and adjusted odds ratios (AOR) with 95% Confidence Intervals (95% CI) were calculated. Results. A total of 7,029 women were included, 29.7% had normal BMI, 33.3% were overweight, 34.8% were obese, and 2.2% were underweight. Obesity was associated with increased odds of gestational diabetes (AOR 2.07, 95% CI 1.73-2.47), hypertensive events in pregnancy (AOR 2.33, 95% CI 1.19-3.91), induction of labour (IOL) (AOR 1.40, 95% CI, 1.19-1.65), failed IOL (AOR 2.13, 95% CI 1.40-3.25), and delivery by emergency caesarean section (CS) (AOR 1.67, 95% CI 1.39-2.01). Infants of obese women had increased odds of macrosomia (AOR 3.73, 95% CI 2.33-5.98). Overweight women had increased odds of CS delivery (AOR 1.25, 95% CI 1.03-1.5) and failed IOL (AOR 1.69, 95% CI 1.09-2.60). Underweight women had increased odds of delivering a low birth weight (LBW) infant (AOR 2.49, 95% CI, 1.58-3.92). Conclusion. The prevalence of prepregnancy overweight and obesity is very high in Saudi Arabia. Prepregnancy obesity is associated with GDM and hypertensive events inpregnancy, IOL, failed IOL, and CS delivery. Infants of obese mothers were at higher risk of macrosomia, while underweight women were at increased risk of delivering LBW infants.

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Section: Discussionmentioning

confidence: 72%

Maternal Prepregnancy Weight and Pregnancy Outcomes in Saudi Women: Subgroup Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

Wahabi

Esmaeil

Fayed

2021

BioMed Research International

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“…Our study is the first cross-sectional study investigating high-risk pregnancy -induction of labor outcomes with misoprostol vaginal insert in obese on-term or late-term patients. Previous studies on the effect of maternal obesity on labor induction evaluated only the late-term pregnancies, induced by multiple therapy protocols with misoprostol, by amniotomy and oxytocin infusion (Maged et al, 2018) [3 -7, 31, 38-40]. Viteri et al (2020) [41] reported this year on nulliparous obese women with IOL, using combined Foley balloon and misoprostol, resulted in similar C-section rates compared to ripening with vaginal misoprostol alone.…”

Section: Strengthsmentioning

confidence: 99%

A New Approach in the Induction of Labor with Misoprostol Vaginal Insert in High-Risk Pregnancy Obese Women

Varlas¹,

Bostan²,

Ba³

et al. 2020

Preprint

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Background and objectives: Induction of labor (IOL) is an event that occurs in up to one-quarter of pregnancies; less is known about the outcomes and safety of IOL in obese pregnant woman; no data is available on misoprostol vaginal insert (MVI) IOL in high-risk pregnancy obese women. Objectives: (1) to evaluate the rate of successful IOL with 200 μg MVI in obese (Body Mass Index - BMI over 30 kg/m2) high-risk pregnant women: late-term pregnancy, hypertension or diabetes, compared to obese non-high-risk ones; (2) to evaluate the safety profile of MVI in high-risk pregnancy obese patients. Study design: We conducted a cross-sectional study in "Filantropia" Clinical Hospital, Bucharest, Romania, from June 2017 to September 2019 (28 months). From a total of 11,096 registered live births, IOL was performed in 206 obese patients; 74 obese high-risk pregnant patients matched the inclusion criteria; of these, 33.8% pregnancies (n=25) were late-term (41 – 41+6 weeks), 43.2% (n=32) had associated pathologies (hypertension and diabetes); labor induction was guided using a standardized protocol. We evaluated the maternal and gestational age, parity, fetal tachysystole, hyper-stimulation, initial cervical status, time from induction to delivery, drug side effects, mode of delivery, and neonatal outcomes. Results: (a) The overall successful labor induction rate, evaluated by the vaginal delivery rate, was 71.6% (n=53), spontaneously or instrumentally assisted; 28.4% (n=21) births were unsuccessful MVI IOL, converted into caesareans. (b) No significant differences were found regarding the maternal outcomes; in terms of perinatal outcomes of safety, four cases of high-risk pregnancies vaginally delivered were associated with neonatal intensive care unit (NICU) admissions and a one-minute Apgar score under seven (5.4%). Most cases with adverse effects of misoprostol have been managed conservatively, except for three emergency C-section cases. Conclusions: Misoprostol vaginal insert is a safe choice in IOL in obese high-risk pregnancies with good maternal and perinatal outcomes.

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“…4 Women with obesity receive more medical interventions during their labors, 5 have slower labors, 6,7 and have a higher risk of cesarean birth, with rates up to 5 times higher than rates of women with a normal body mass index (BMI). 8,9 Safe prevention of cesarean birth in women with a high BMI is especially important, as this population is also at increased risk of morbidity and mortality following cesarean birth. [10][11][12][13][14] The aim of this study was to evaluate the effectiveness of the unit-level presence of midwives on the odds of cesarean birth in women of different BMI ranges.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, 27.1% of women in the United States are obese prior to pregnancy, and in non‐Hispanic black women, the prevalence of obesity is even higher, approaching 40% . Women with obesity receive more medical interventions during their labors, have slower labors, and have a higher risk of cesarean birth, with rates up to 5 times higher than rates of women with a normal body mass index (BMI) . Safe prevention of cesarean birth in women with a high BMI is especially important, as this population is also at increased risk of morbidity and mortality following cesarean birth .…”

Section: Introductionmentioning

confidence: 99%

Preventing Cesarean Birth in Women with Obesity: Influence of Unit‐Level Midwifery Presence on Use of Cesarean among Women in the Consortium on Safe Labor Data Set

Carlson

Breman

Neal

et al. 2019

J Midwife Womens Health

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Introduction: Maternal obesity is associated with slow labor progression and unplanned cesarean birth. Midwives use fewer medical interventions during labor, and the women they care for have lower cesarean birth rates, compared with low-risk, matched groups of women cared for by physicians. The primary aim of this study was to examine associations between midwifery unit-level presence and unplanned cesarean birth in women with different body mass index (BMI) ranges. Unit-level presence of midwives was analyzed as a representation of a unique set of care practices that exist in settings where midwives work. Methods: A retrospective cohort study was conducted using Consortium on Safe Labor data from low-risk, healthy women who labored and gave birth in medical centers with (n = 9795) or without (n = 13,398) the unit-level presence of midwives. Regression models were used to evaluate for associations between unit-level midwifery presence and 1) the incidence of unplanned cesarean birth and 2) in-hospital labor durations with stratification by maternal BMI and adjustment for maternal demographic and pregnancy factors. Results: The odds of unplanned cesarean birth among women who gave birth in centers with midwives were 16% lower than the odds of cesarean birth among similar women at who gave birth at centers without midwives (adjusted odds ratio, 0.84; 95% CI, 0.77-0.93). However, women whose BMI was above 35.00 kg/m 2 at labor admission had similar odds of cesarean birth, regardless of unit-level midwifery presence. In-hospital labor duration prior to unplanned cesarean was no different by unit-level midwifery presence in nulliparous women whose BMI was above 35.00 kg/m 2. Discussion: Although integration of midwives into the caregiving environment of medical centers in the United States was associated with overall decrease in the incidence of cesarean birth, increased maternal BMI nevertheless remained positively associated with these outcomes.

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Effect of maternal obesity on labor induction in postdate pregnancy

Abstract: NCT02788305.

Cited by 27 publications

References 18 publications

Maternal Prepregnancy Weight and Pregnancy Outcomes in Saudi Women: Subgroup Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

Maternal Prepregnancy Weight and Pregnancy Outcomes in Saudi Women: Subgroup Analysis from Riyadh Mother and Baby Cohort Study (RAHMA)

A New Approach in the Induction of Labor with Misoprostol Vaginal Insert in High-Risk Pregnancy Obese Women

Preventing Cesarean Birth in Women with Obesity: Influence of Unit‐Level Midwifery Presence on Use of Cesarean among Women in the Consortium on Safe Labor Data Set

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