The effect of maternal obesity on labour and labour pain

Abstract

Consecutive obese (n = 53) and non-obese parturients (n = 609) were prospectively evaluated during labour to analyse the influence of maternal obesity on labour pain and outcome. Excessive pre-pregnancy weight was classified as a body mass index of 30 kg.m-2 or more. Pain intensity was measured using an 11 point visual scoring scale. Obese parturients had more complicated pregnancies (hypertension and diabetes) and their babies weighed significantly more (3865 g versus 3592 g, p < 0.001). These differences did not affect labour pain experience, or the duration or mode of delivery. Eighty-five percent of the obese parturients and 83% of the controls had high maximal pain scores during the first stage (> 7). Both groups received similar analgesia. More technical problems (p = 0.03) were experienced in establishing epidural analgesia for obese parturients, but this did not influence the success of pain treatment. After delivery, obese women were significantly more content with the pain relief received; only 12% vs 23% in the control group complained of poor pain control (p = 0.03). In this study, obesity and increased fetal size did not complicate labour or its outcome. Critical patient assessment should be emphasised, however, due to the physiological and medical problems present in obese parturients.

The Impact of Obesity on Obstetrical Practice and Outcome

“…Perlow et al 48 reported that massively obese gravidas (.300 lb) more commonly experience initial epidural failure. In comparison, Ranta et al 57 reported that obese parturients (BMI $30) as compared to controls, experienced more technical problems in establishing epidural anesthesia, such as inadvertent dural puncture, multiple attempts at placement, and senior anesthetist consultation, but experienced an equal response to pain treatment. The greater incidence of medical and antenatal complications, increased risk for cesarean delivery, and higher incidence of anesthetic complications necessitates timely anesthetic evaluation in all obese parturients.…”

The Role of Maternal Attachment in the Experience of Labor Pain

“…Although some data have suggested a positive association between labour pain and the pre-pregnancy body mass index (BMI) (32), this relationship has not been confirmed in other studies (38,39). Finally, some studies have also stressed the importance of childbirth training in decreasing labour pain (32,40).…”

Pregnancy and obesity: practical implications

“…Obese patients experience the same amount of pain during labour as nonobese women and have been found to be more satisfied with pain relief measures [135].…”