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Author Notes:

Dr. Cassandra M. Gibbs Pickens, PhD, MPH, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322. Phone: (404) 855-1166. Fax: (404) 727-8737. cassandra.pickens@gmail.com.

Each author has indicated that he or she has met the journal’s requirements for authorship.

The authors did not report any potential conflicts of interest.

Subjects:

Research Funding:

Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (Grant 5T32HD052460-10, Emory University), Maternal and Child Health Bureau, Health Resources and Services Administration (Grant T03MC07651, Emory University), and Emory University Laney Graduate School.

The funders had no role in study design; in data collection, analysis, or interpretation; in the writing of the manuscript; or in the decision to submit the article for publication.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Obstetrics & Gynecology

Term Elective Induction of Labor and Pregnancy Outcomes Among Obese Women and Their Offspring

Tools:

Journal Title:

Obstetrics and Gynecology

Volume:

Volume 131, Number 5

Publisher:

, Pages 937-937

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective To evaluate whether elective induction of labor between 39 through 41 weeks, as compared to expectant management, is associated with reduced cesarean delivery and other adverse outcomes among obese women and their offspring. Methods We conducted a retrospective cohort study using the 2007–2011 California Linked Patient Discharge Data–Birth Cohort File of 165,975 singleton, cephalic, non-anomalous deliveries to obese women. For each gestational week (39–41), we used multivariable logistic regression models, stratified by parity, to assess whether elective induction of labor or expectant management was associated with lower odds of cesarean delivery and other adverse outcomes. Results At 39 and 40 weeks, cesarean delivery was less common in obese nulliparous women who were electively induced versus those who were expectantly managed (at 39 weeks, frequencies were 35.9% versus 41.0%, respectively [p<0.05]; adjusted odds ratio [OR] [95% Confidence Interval (CI)]: 0.82 [0.77, 0.88]). Severe maternal morbidity was less frequent among electively induced obese nulliparous patients (at 39 weeks, 5.6% versus 7.6% [p<0.05]; adjusted OR: 0.75 [95% CI 0.65, 0.87]). Neonatal intensive care unit (NICU) admission was less common among electively induced obese nulliparous women (at 39 weeks, 7.9% versus 10.1% [p<0.05]; adjusted OR: 0.79 [95% CI 0.70, 0.89]). Patterns were similar among obese parous women at 39 weeks (crude frequencies and adjusted ORs [95% CIs] were as follows: for cesarean delivery, 7.0% versus 8.7% [p<0.05], and 0.79 [0.73, 0.86]; for severe maternal morbidity, 3.3% versus 4.0% [p<0.05], and 0.83 [0.74, 0.94]; for NICU admission: 5.3% versus 7.4% [p<0.05], and 0.75 [0.68, 0.82]). Similarly, elective induction at 40 weeks was associated with reduced odds of cesarean delivery, maternal morbidity, and NICU admission among both obese nulliparous and parous patients. Conclusion Elective labor induction after 39 weeks was associated with reduced maternal and infant morbidity among obese women. Further prospective investigation is necessary.

Copyright information:

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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