Is a Maternal Prepregnancy Weight Effective in the Pattern of Labor Progression of Nulliparous Women?

Park, Young Jin; Ahn, You Jung; Han, Seong Ho; Park, Joo Sung; Kim, Tae Hyung

Abstract

BACKGROUND: Observational studies show that obese women have up to a 2-fold increased risk for a cesarean delivery compared with normal-weight women. However, it is unclear what factors may contribute to this elevated risk. The purpose of this study was to examine the effect of maternal overweight and obesity on the pattern of labor progression in nulliparous women with a singleton, pregnancy.
METHODS
We analyzed data from 406 nulliparous women with a pregnancy that visited in department of Obstetrics & Gynecology, College of Medicine, University of Dong-A from 1990 to 2007. The median duration of labor by each centimeter of cervical dilation was computed for normal-weight (18.5 kg/m2 < or = body mass index[BMI] < 23 kg/m2), overweight (23 kg/m2 < or = BMI < 25 kg/m2), and obese (BMI > or = 25.0 kg/m2) women and used as a measurement of labor progression.
RESULTS
After adjusting for maternal height, labor induction, membrane rupture, oxytocin use, method of anesthesia, net maternal weight gain, and fetal size, the median duration of labor from 4 to 10 cm was significantly longer for both overweight and obese women, compared with normal-weigh women(12.6, 10.73, and 4.4 hours, respectively). For overweight women, the prolongation was concentrated around 4~8 cm, whereas for obese women, the prolongation was concentrated around 5~9 cm.
CONCLUSION
Given that the prevalence of overweight and obesity is increasing among women of childbearing age, it is critical to consider differences in labor progression by maternal prepregnancy BMI before additional interventions are performed.