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Obstet Gynecol. 2004 Mar;103(3):452-6.

The association of maternal weight with cesarean risk, labor duration, and cervical dilation rate during labor induction.

Author information

1
Center for Research in Women's Health, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 619 19th Street South, OHB 451, Birmingham, AL 35249-7333, USA. francis@nuthalapaty.net

Erratum in

  • Obstet Gynecol. 2004 May;103(5 Pt 1):1019.

Abstract

OBJECTIVE:

To assess the relationship among maternal weight and cesarean delivery, cervical dilation rate, and labor duration.

METHODS:

We used a secondary analysis of 509 term women who were previously enrolled in a prospective observational study of a labor induction protocol in which standardized criteria were used for labor management. A variety of analyses were performed, both unadjusted and adjusted. P <.05 was considered significant.

RESULTS:

The mean +/- standard deviation weight of women who underwent a cesarean (97 +/- 29 kg) was significantly higher than that of women who were delivered vaginally (87 +/- 22 kg, P <.001). In a logistic regression model of nulliparas who comprised 71% of the study population, after adjustment for the confounding effects of infant birth weight, maternal age, initial cervical dilation, and diabetes, for each 10-kg increase in maternal weight, the odds ratio for cesarean delivery was significantly increased (odds ratio 1.17; 95% confidence interval 1.04, 1.28). In a linear regression model also limited to nulliparas and after adjusting for the same confounders, the rate of cervical dilation was inversely associated with maternal weight: for each 10-kg increment, the rate of dilation was decreased by 0.04 cm/h (P =.05). Similarly, labor duration was positively associated with maternal weight: for each 10-kg increment, an increase in the oxytocin to delivery interval of 0.3 hours was observed in nulliparas (P =.02). Neither lower rates of oxytocin administration to heavier women nor diminished uterine responsiveness (as reflected in measured Montevideo units) accounted for the slower labor progress.

CONCLUSION:

In nulliparous women undergoing labor induction, maternal weight was associated with a higher cesarean risk and longer labor and was inversely proportional to the cervical dilation rate.

LEVEL OF EVIDENCE:

II-2

[Indexed for MEDLINE]

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