Gestational weight gain as a risk factor for dystocia during first delivery: a multicenter retrospective cohort study in Japan

Kyozuka, Hyo; Hiraiwa, Tomoko; Murata, Tsuyoshi; Sugeno, Misa; Jin, Toki; Ito, Fumihito; Suzuki, Daisuke; Nomura, Yasuhisa; Fukuda, Toma; Yasuda, Shun; Fujimori, Keiya

doi:10.1186/s12884-022-05055-6

Cited by 9 publications

(14 citation statements)

References 41 publications

(58 reference statements)

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“…A larger sample size may provide valuable information about hematological changes for the prediction of both primipara and multipara status. To overcome this issue, we are currently conducting further research using a multicenter analysis model [33]. Third, because we chose control cases based on the maternal background of patients with Lo-HDP, these may not have represented truly healthy maternity.…”

Section: Discussionmentioning

confidence: 99%

Late-onset hypertensive disorders of pregnancy and red blood cell distribution width during late pregnancy among Japanese primipara: A nested case-control study

Sugeno

Kyozuka

Jin

et al. 2023

Preprint

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Background This study aimed to compare the red blood cell distribution width (RDW) between patients with late-onset hypertensive disorders of pregnancy (HDP) and healthy pregnant Japanese primiparas. Methods This nested case-control study was conducted at Ohta Nishinouchi Hospital in Fukushima, Japan, from 2014 to 2020. We included 110 patients with late-onset HDP and 110 propensity score-matched control participants with healthy pregnancies. Late-onset HDP was further categorized into gestational hypertension (n = 43) and preeclampsia (n = 67). The RDW was compared between the control and HDP groups during the first and third trimesters. Generalized linear mixed models (GLMMs) were used to examine changes in RDW during the two phases in the control and HDP groups. Results In the comparison between the control and HDP groups, no significant difference was noted in the median RDW during the first trimester (p = 0.569) or median RDW during the third trimester (p = 0.570). Comparing the gestational hypertension and preeclampsia groups, there was no significant difference in the RDW at the first (p = 0.179) and third trimesters (p = 0.828). The GLMMs showed significant phase changes in the RDW in both the control (p < 0.05) and HPD (p < 0.05) groups. Conclusions Although the RDW increased as the pregnancy progressed in the late-onset HDP group, the same changes were observed in the control group. RDW changes common to all groups may reflect maternal inflammatory responses that occur during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Late-onset hypertensive disorders of pregnancy and red blood cell distribution width during late pregnancy among Japanese primipara: A nested case-control study

Sugeno

Kyozuka

Jin

et al. 2023

Preprint

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“…A primary strength of the current study is that patient data were derived from two tertiary care fetal medicine units in which all patients were managed by obstetricians with equivalent training for obstetric emergencies [15]. Nonetheless, this study has potential limitations.…”

Section: Discussionmentioning

confidence: 99%

“…This multicenter retrospective cohort study was conducted in two tertiary Maternal-Fetal medicine units in Fukushima Prefecture, Japan [15]. The study population consisted of pregnant women who delivered at either of these two units between January 1, 2013, and December 31, 2020.…”

Section: Patientsmentioning

confidence: 99%

“…Participants were categorized into the following six groups (G), according to pre-pregnancy BMI: G1, < 18.5 kg/m 2 ; G2, 18.5 to < 20.0 kg/m 2 ; G3, 20.0 to < 23.0 kg/m 2 ; G4, 23.0 to < 25.0 kg/m 2 ; G5 (25.0 to < 30.0 kg/m 2 ), and G6 (≥ 30.0 kg/m 2 ) [15,[19][20][21]. In the study setting, cervical length was routinely measured between 28 and 30 weeks of gestation, with placenta previa de ned when the placenta completely covered the internal os of the cervix.…”

Section: Maternal and Neonatal Informationmentioning

confidence: 99%

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Predicting postpartum hemorrhage in women undergoing planned cesarean section: a multicenter retrospective cohort study in Japan

Yamaguchi

Kyozuka

Ito

et al. 2023

Preprint

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Background Given Japan’s unique social background, it is critical to understand the current risk factors for postpartum hemorrhage (PPH) to effectively manage the condition, especially among specific groups. Therefore, this study aimed to clarify the current risk factors for blood loss during planned cesarean section (CS) in Japan.Methods This multicenter retrospective cohort study was conducted in two tertiary maternal-fetal medicine units in Fukushima, Japan and included 1,133 women who underwent planned CS between January 1, 2013, and December 31, 2022. Risk factors for PPH (of > 1000 g, > 1500 g, and > 2000 g) were assessed using multivariate logistic regression analysis, considering variables such as maternal age, parity, assisted reproductive technology (ART) pregnancy, pre-pregnancy body mass index (BMI), uterine myoma, placenta previa, gestational age at delivery, birth weight categories, and hypertensive disorders of pregnancy (HDP). Multivariate linear regression analyses were conducted to predict PPH risk during planned CS.Results ART pregnancy, pre-pregnancy BMI (25.0–29.9 kg/m2), placenta previa, and uterine myoma increased PPH risk at various levels. Maternal smoking increased the risk of > 2000 g PPH (adjusted odds ratio: 11.6, 95% confidence interval [CI]: 2.85–46.9). Multivariate linear analysis showed that advanced maternal age (B: 75 g; 95% CI: 21–128 g), ART pregnancy (B: 163 g; 95% CI: 50–275 g), pre-pregnancy BMI of 25.0 to < 30.0 kg/m2 (B: 94 g; 95% CI: 22–167 g), uterine myoma (B: 189 g; 95% CI: 89–288 g), placenta previa (B: 558 g; 95% CI: 453–662 g), and birth weight > 3,500 g (B: 173 g; 95% CI: 44–303 g).Conclusions Considering a patient’s social background may help predict bleeding in planned CSs and help improve patient safety.

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“…In particular, no studies have investigated the association between GWG and intrapartum oxytocin administration. Previous studies have found evidence that excessive/high GWG may be associated with dystocia, 8 shoulder dystocia, 9 CS due to dystocia, 10 or dysfunctional labor, 11 and emergency/intrapartum/non-elective CS, 9,[12][13][14][15][16][17][18] but the applicability of these studies to contemporary French or European obstetric populations is limited. Specifically, many of these studies were conducted in Asian 8,10,11 or other non-European 9,[13][14][15]19 populations.…”

Section: Introductionmentioning

confidence: 99%

Gestational weight gain adequacy and intrapartum oxytocin and cesarean section use: Observational population‐based study in France

Amyx

Zeitlin

Blondel

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Research on maternal prepregnancy weight suggests adiposity is associated with dysfunctional labor, but knowledge about how gestational weight gain (GWG) affects labor is sparse. Our objective was to evaluate associations between GWG adequacy and intrapartum obstetric interventions (oxytocin administration; cesarean section) necessitated by labor dysfunction. Material and methods Using national, population‐based French National Perinatal Survey 2016 data, we included term cephalic singleton pregnancies involving trial of labor (n = 9724). For the intrapartum oxytocin administration analysis, we included only women with spontaneous labor (n = 7352). GWG was calculated as the difference between end of pregnancy and prepregnancy weight (both self‐reported) and categorized as insufficient, adequate (reference group), or excessive by prepregnancy body mass index (BMI; underweight <18.5, normal weight 18.5–24.9, overweight 25–29.9, obese ≥30 kg/m2) using the 2009 Institute of Medicine thresholds. Multilevel generalized estimating equation logistic regression models, unadjusted and adjusted for a priori confounders, evaluated intervention‐GWG adequacy associations within BMI categories (under/normal weight combined), stratified by parity (primiparas; multiparas). Results GWG adequacy was associated with oxytocin use among under/normal weight women (primiparas: insufficient 57.3%, adequate 60.8%, excessive 65.0%, p = 0.014; multiparas: insufficient 27.2%, adequate 29.1%, excessive 36.2%, p < 0.001) and overweight primiparas (insufficient 56.0%, adequate 58.7%, excessive 72.5%, p = 0.002). In unadjusted and adjusted models, trends of increased odds of oxytocin administration among women with excessive GWG were found regardless of parity and prepregnancy BMI. Similarly, among under/normal weight women, GWG adequacy was associated with intrapartum cesarean section (primiparas: insufficient 10.7%, adequate 12.7%, excessive 15.3%, p = 0.014; multiparas: insufficient 3.1%, adequate 3.5%, excessive 6.3%, p < 0.001) with increased cesarean section among multiparas with excessive GWG persisting in adjusted models (adjusted odds ratio 1.9, 95% confidence interval 1.3–2.7). However, intrapartum cesarean section was reduced among multiparas with overweight and obese prepregnancy BMI and excessive GWG. Conclusions Excessive GWG was associated with intrapartum oxytocin administration, regardless of parity or prepregnancy BMI, and cesarean section among women with under/normal weight prepregnancy BMI, providing evidence for benefits of healthy GWG for normal labor progression. Additional research is needed to verify our findings and understand differences by BMI.

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Gestational weight gain as a risk factor for dystocia during first delivery: a multicenter retrospective cohort study in Japan

Cited by 9 publications

References 41 publications

Late-onset hypertensive disorders of pregnancy and red blood cell distribution width during late pregnancy among Japanese primipara: A nested case-control study

Late-onset hypertensive disorders of pregnancy and red blood cell distribution width during late pregnancy among Japanese primipara: A nested case-control study

Predicting postpartum hemorrhage in women undergoing planned cesarean section: a multicenter retrospective cohort study in Japan

Gestational weight gain adequacy and intrapartum oxytocin and cesarean section use: Observational population‐based study in France

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