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BJOG. 2016 Jan;123(2):271-8. doi: 10.1111/1471-0528.13807.

Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study.

Author information

1
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
2
National Public Health Institute, Cuernvaca, Mexico.
3
Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA.
4
California Pacific Medical Center, San Francisco, CA, USA.
5
Sutter Health System, Sacramento, CA, USA.
6
University of California, Irvine, CA, USA.

Abstract

OBJECTIVE:

To compare perinatal outcomes between elective induction of labour (eIOL) and expectant management in obese women.

DESIGN:

Retrospective cohort study.

SETTING:

Deliveries in California in 2007.

POPULATION:

Term, singleton, vertex, nonanomalous deliveries among obese women (n = 74 725).

METHODS:

Women who underwent eIOL at 37 weeks were compared with women who were expectantly managed at that gestational age. Similar comparisons were made at 38, 39, and 40 weeks. Results were stratified by parity. Chi-square tests and multivariable logistic regression were used for statistical comparison.

MAIN OUTCOME MEASURES:

Method of delivery, severe perineal lacerations, postpartum haemorrhage, chorioamnionitis, macrosomia, shoulder dystocia, brachial plexus injury, respiratory distress syndrome.

RESULTS:

The odds of caesarean delivery were lower among nulliparous women with eIOL at 37 weeks [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.34-0.90] and 39 weeks (OR 0.77, 95% CI 0.63-0.95) compared to expectant management. Among multiparous women with a prior vaginal delivery, eIOL at 37 (OR 0.39, 95% CI 0.24-0.64), 38 (OR 0.65, 95% CI 0.51-0.82), and 39 weeks (OR 0.67, 95% CI 0.56-0.81) was associated with lower odds of caesarean. Additionally, eIOL at 38, 39, and 40 weeks was associated with lower odds of macrosomia. There were no differences in the odds of operative vaginal delivery, lacerations, brachial plexus injury or respiratory distress syndrome.

CONCLUSIONS:

In obese women, term eIOL may decrease the risk of caesarean delivery, particularly in multiparas, without increasing the risks of other adverse outcomes when compared with expectant management.

KEYWORDS:

Caesarean delivery; elective induction of labour; maternal obesity

PMID:
26840780
PMCID:
PMC4742358
DOI:
10.1111/1471-0528.13807
[Indexed for MEDLINE]
Free PMC Article

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