Spontaneous Labor Onset and Outcomes in Obese Women at Term

Abstract

Objective The objective of this study was to compare the rates of spontaneous labor onset and its progression in obese and nonobese women after 37 weeks. Study Design We performed a secondary analysis of a retrospective cohort of all women who were admitted for delivery at ≥ 37 weeks of gestation at a university-based tertiary care center between 2004 and 2010. The cohort was stratified by weeks of gestation at which the patient presented for delivery. The rates of spontaneous labor, vaginal delivery, and augmentation with oxytocin were compared between obese (body mass index [BMI] ≥ 30) and nonobese (BMI < 30) women. Results Obese women had lower rates of spontaneous labor than nonobese women at every gestational week (37 weeks, 6.1 vs. 9.3%, p < 0.001; 38 weeks, 12.8 vs. 19.2%, p < 0.001; 39 weeks 26.0 vs. 37.0%, p < 0.001; 40 weeks, 39.6 vs. 50.2%, p < 0.001; 41 weeks, 30.8 vs. 38.0%, p < 0.012). Among women who presented in spontaneous labor, obesity was associated with higher rates of augmentation with oxytocin and lower rates of vaginal delivery. Conclusion Obese women at or beyond 37 weeks are less likely to experience spontaneous labor compared with nonobese women. In addition, obese women presenting in spontaneous labor are less likely that nonobese women to have a vaginal delivery at 37 to 40 weeks, even after oxytocin augmentation.

Independent effect of gestational weight gain and prepregnancy obesity on pregnancy outcomes among Saudi women: A sub-cohort analysis from Riyadh mother and baby cohort study (RAHMA)

“…It is not surprising that obese women in this study had almost twofold the risk of CS delivery compared to normal weight women considering the high prevalence of obstetric complications such as preeclampsia and GDM in addition to the increased risk of fetal macrosomia among them. Similar findings were reported in other cohorts [ 40 , 41 ]. The risk of CS delivery was found to increase by 1.4-fold in overweight women compared to normal weight women and almost three times more in morbidly obese women [ 41 ].…”

Obstetrician-Gynecologists' Strategies for Patient Initiation and Maintenance of Antiobesity Treatment with Glucagon-Like Peptide-1 Receptor Agonists

“… 25–27 Obesity decreases the incidence of spontaneous labor and increases the risk of prolonged pregnancy and cesarean section, with associated risk of wound infections. 4 , 25 , 26 , 28 , 29 In a systematic review and meta-analysis, risk of caesarean delivery in nulliparous women was 50% higher with overweight (BMI ≥25 to <30 kg/m 2 ), double with class I obesity (mild obesity; BMI ≥30 to <35 kg/m 2 ), and triple with class II/III obesity (moderate and severe obesity; BMI ≥35 to <40 and ≥40 kg/m 2 ), compared with women of normal BMI. 30 …”