Effect of Obesity on Length of Labor in Nulliparous Women

Abstract

We compared the duration of labor among nulliparous women with varying body mass index (BMI). Laboring nulliparous women at >37 weeks were included. First visit BMI was used to categorize weight as normal (≤24), overweight (25 to 29.9), or obese (≥30 kg/m(2)). Chi-square, one-way analysis of variance, and Bonferroni multiple comparisons tests were used. During 15 months, 375 women met the inclusion criteria, and 38% were obese. Duration of first stage of labor was significantly longer for obese versus normal-weight women (26.76 ± 0.77 versus 23.87 ± 0.66 hours; p = 0.024) but not between normal versus overweight women (p = 1.00) or overweight versus obese women (p = 0.114). The cesarean delivery rate was significantly different in the three groups (p = 0.0001), highest among obese (47%) and lowest in normal-weight women (24%). When adjusted for age, hypertension, and induction, the likelihood of completing stage I was significantly less among obese nulliparous than those with BMI < 24 kg/m(2) (hazard ratio 0.73, 95% confidence intervals 0.54, 0.99). Compared with those with BMI < 24, the duration of stage I is significantly longer among obese women, even when adjusted for maternal age, induction, and hypertension.

Maternal obesity, duration of labor and the role of leptin

“…If a CS may be avoided among these women, the chances are great that their following deliveries will be normal and uncomplicated. The results of previous studies that demonstrated the time in labor increases with maternal BMI are difficult to compare because of the different definitions of maternal obesity and active labor employed and the inclusion of mixed parities with both spontaneous and induced labor onset (45,(49)(50)(51)104). However, the results from our study support previous findings that the time in active labor significantly increases with maternal BMI.…”

“…During labor, the process of cervical dilation is slower in obese women than normal weight women (25,49,50) and the duration of active labor increases with maternal BMI (45). It appears as if the prolonged duration of labor in obese women is restricted to the active phase of labor, particularly before 6-7 cm of cervical dilatation (45,(49)(50)(51).…”

“…It appears as if the prolonged duration of labor in obese women is restricted to the active phase of labor, particularly before 6-7 cm of cervical dilatation (45,(49)(50)(51). This is supported by studies that indicate the duration of the second stage of labor in nulliparous women is similar irrespective of maternal BMI (45,52) and that the pushing ability is not related to maternal BMI (53).…”

Outcomes of Nulliparous Women with Spontaneous Labor Onset Admitted to Hospitals in Pre‐active versus Active Labor

“…[22][23][24] This is important because maternal obesity has been identified as an independent risk factor for cesarean section in multiple studies, largely due to more diagnoses of slow labor progress. [25][26][27][28][29][30][31] For nulliparous women, cesarean risk increases by 5% for each unit increase in BMI (i.e., 1 kg/m 2 ). 30 Although the reason for slower first stage progress among obese women remains largely unknown, it may be appropriate for clinicians to be even more patient when evaluating labor progress among women with a higher BMI.…”

The Effects Of The Maternal Body Mass Index On Duration Of Labor, Mode Of Delivery, Neonatal Birth Weight Apgar Score And Postpartum Complications

“…Çalışmamızda değerlendir-meye alınan olguların vücut kitle indeksine göre travay süreleri incelendiğinde istatistiksel olarak anlamlı bir fark görülmemiştir (p = 0,952). Hilliard'ın çalışmasında obez nullipar gebelerde doğumun 1.evresinin anlamlı derecede uzun olduğu belirlenmiş-tir (13). Pevzner'in çalışmasında maternal obezitenin indüksiyonla doğumu başlatılan gebelerde travay sü-resini uzattığı gösterilmiştir (14).…”