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Effect of maternal obesity on labor induction in postdate pregnancy

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To test the hypothesis that there is a higher rate of unsuccessful induction of labor (IOL) in post-term obese pregnant women compared to non-obese ones.

Methods

In this prospective cohort study, 144 obese (BMI > 30) and 144 non-obese (BMI < 29.9) post-term (> 41 weeks) pregnant women were recruited. IOL was done by misoprostol or amniotomy and oxytocin infusion according to the Bishop score. Comparison of percentage of failed IOL in both groups (primary outcome) was performed by the Chi-test. Logistic regression and multivariable regression were performed to assess the odds ratio (OR) of cesarean section (CS) and coefficient of delay in labor till vaginal delivery (VD) in obese versus (vs) non-obese groups. Adjustment for gestational age, parity, Bishop Score, membrane rupture and amniotic fluid index was done in both regression analyses.

Results

CS rate was significantly higher in obese group [26.4 vs 15.9%; difference in proportion (95% CI) 0.1 (0.01, 0.19); P value 0.02]. 106 (73.6%) obese women and 121 (84.1%) non-obese women delivered vaginally. In addition, the duration till VD was significantly higher in obese group (22 vs 19 h, P value 0.01). After adjustment for possible confounding factors, the CS was still higher in the obese group in comparison to non-obese group (OR 2.02; 95% CI 1.1, 3.7; P value 0.02). This finding suggested that obesity was an independent factor for failure of IOL. In addition, after adjustment for these confounders, obesity had the risk of increasing labor duration by 2.3 h (95% CI 0.1, 4.5) in cases that ended in VD.

Conclusion

Based on our results, we conclude that there is a higher risk of CS in obese postdate pregnant women undergoing IOL in comparison to non-obese counterparts. Therefore, obstetricians should pay more attention to advising pregnant women about optimal weight gain during pregnancy and counseling about the chances of VD in cases of IOL.

ClincalTrial.gov ID

NCT02788305.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt

    Ahmed M. Maged, Ali M. El-Semary, Heba M. Marie, Doaa S. Belal, Ayman Hany, Mohammad A. Taymour, Eman F. Omran & Mohamed A. Kamal Mohamed

  2. Department of Obstetrics and Gynecology, Fayoum University, Fayoum, Egypt

    Sahar M. Y. Elbaradie

Authors
  1. Ahmed M. Maged
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  2. Ali M. El-Semary
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  3. Heba M. Marie
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  4. Doaa S. Belal
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  5. Ayman Hany
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  6. Mohammad A. Taymour
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  7. Eman F. Omran
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  8. Sahar M. Y. Elbaradie
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  9. Mohamed A. Kamal Mohamed
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Contributions

AM: project development. AE-S: project development and revision of data. HM: project development, data collection and revision of the manuscript. DB: review of literature, data collection and manuscript writing. AA: data collection. EO: review of literature, data analysis and manuscript writing. MT: data collection. SE: manuscript revision. MK: data collection.

Corresponding author

Correspondence to Ahmed M. Maged.

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Conflict of interest

The author reports no conflicts of interest in this work.

Ethical approval

The study was performed in accordance with the Declaration of Helsinki ethical standards.

Informed consent

Informed consents were taken from study participants.

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Maged, A.M., El-Semary, A.M., Marie, H.M. et al. Effect of maternal obesity on labor induction in postdate pregnancy. Arch Gynecol Obstet 298, 45–50 (2018). https://doi.org/10.1007/s00404-018-4767-8

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  • DOI: https://doi.org/10.1007/s00404-018-4767-8

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