Contemporary labor patterns: The impact of maternal body mass index

Michelle A. Kominiarek; Jun Zhang; Paul Vanveldhuisen; James Troendle; Julie Beaver; Judith U. Hibbard

doi:10.1016/j.ajog.2011.06.014

Contemporary labor patterns: The impact of maternal body mass index

Michelle A. Kominiarek^*, Jun Zhang, Paul Vanveldhuisen, James Troendle, Julie Beaver, Judith U. Hibbard

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

140 Scopus citations

Abstract

Objective: We sought to compare labor patterns by body mass index (BMI). Study Design: A total of 118,978 gravidas with a singleton term cephalic gestation were studied. Repeated-measures analysis constructed mean labor curves by parity and BMI categories for those who reached 10 cm. Interval-censored regression analysis determined median traverse times, adjusting for covariates in vaginal deliveries and intrapartum cesareans. Results: In the labor curves, the time difference to reach 10 cm was 1.2 hours from the lowest to highest BMI category for nulliparas. Multiparas entered active phase by 6 cm, but reaching this point took longer for BMI <40.0 (3.4 hours) compared to BMI <25.0 (2.4 hours). Progression by centimeter (P <.001 for nulliparas) and from 4-10 cm (P <.001 for nulliparas and multiparas) increased as BMI increased. Second stage length, with and without an epidural, was similar among BMI categories for nulliparas (P >.05) but decreased as BMI increased for multiparas (P <.001). Conclusion: Labor proceeds more slowly as BMI increases, suggesting that labor management be altered to allow longer time for these differences.

Original language	English (US)
Pages (from-to)	244.e1-244.e8
Journal	American journal of obstetrics and gynecology
Volume	205
Issue number	3
DOIs	https://doi.org/10.1016/j.ajog.2011.06.014
State	Published - Sep 2011

Keywords

body mass index
labor curves
obesity
pregnancy

ASJC Scopus subject areas

Obstetrics and Gynecology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ajog.2011.06.014

Cite this

@article{d30370cdc70e4097a1a595896567bb69,

title = "Contemporary labor patterns: The impact of maternal body mass index",

abstract = "Objective: We sought to compare labor patterns by body mass index (BMI). Study Design: A total of 118,978 gravidas with a singleton term cephalic gestation were studied. Repeated-measures analysis constructed mean labor curves by parity and BMI categories for those who reached 10 cm. Interval-censored regression analysis determined median traverse times, adjusting for covariates in vaginal deliveries and intrapartum cesareans. Results: In the labor curves, the time difference to reach 10 cm was 1.2 hours from the lowest to highest BMI category for nulliparas. Multiparas entered active phase by 6 cm, but reaching this point took longer for BMI <40.0 (3.4 hours) compared to BMI <25.0 (2.4 hours). Progression by centimeter (P <.001 for nulliparas) and from 4-10 cm (P <.001 for nulliparas and multiparas) increased as BMI increased. Second stage length, with and without an epidural, was similar among BMI categories for nulliparas (P >.05) but decreased as BMI increased for multiparas (P <.001). Conclusion: Labor proceeds more slowly as BMI increases, suggesting that labor management be altered to allow longer time for these differences.",

keywords = "body mass index, labor curves, obesity, pregnancy",

author = "Kominiarek, {Michelle A.} and Jun Zhang and Paul Vanveldhuisen and James Troendle and Julie Beaver and Hibbard, {Judith U.}",

note = "Funding Information: The data included in this paper were obtained from the Consortium on Safe Labor, which was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, through contract no. HHSN267200603425C. Institutions involved in the Consortium include, in alphabetical order: Baystate Medical Center, Springfield, MA; Cedars-Sinai Medical Center Burnes Allen Research Center, Los Angeles, CA; Christiana Care Health System, Newark, DE; Georgetown University Hospital, MedStar Health, Washington, DC; Indiana University Clarian Health, Indianapolis, IN; Intermountain Healthcare and the University of Utah, Salt Lake City, Utah; Maimonides Medical Center, Brooklyn, NY; MetroHealth Medical Center, Case Western University, Cleveland, OH; Summa Health System, Akron City Hospital, Akron, OH; The EMMES Corporation, Rockville, MD (Data Coordinating Center); University of Illinois at Chicago, Chicago, IL; University of Miami, Miami, FL; and University of Texas Health Science Center at Houston, Houston, TX.",

year = "2011",

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T2 - The impact of maternal body mass index

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AU - Zhang, Jun

AU - Vanveldhuisen, Paul

AU - Troendle, James

AU - Beaver, Julie

AU - Hibbard, Judith U.

N1 - Funding Information: The data included in this paper were obtained from the Consortium on Safe Labor, which was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, through contract no. HHSN267200603425C. Institutions involved in the Consortium include, in alphabetical order: Baystate Medical Center, Springfield, MA; Cedars-Sinai Medical Center Burnes Allen Research Center, Los Angeles, CA; Christiana Care Health System, Newark, DE; Georgetown University Hospital, MedStar Health, Washington, DC; Indiana University Clarian Health, Indianapolis, IN; Intermountain Healthcare and the University of Utah, Salt Lake City, Utah; Maimonides Medical Center, Brooklyn, NY; MetroHealth Medical Center, Case Western University, Cleveland, OH; Summa Health System, Akron City Hospital, Akron, OH; The EMMES Corporation, Rockville, MD (Data Coordinating Center); University of Illinois at Chicago, Chicago, IL; University of Miami, Miami, FL; and University of Texas Health Science Center at Houston, Houston, TX.

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N2 - Objective: We sought to compare labor patterns by body mass index (BMI). Study Design: A total of 118,978 gravidas with a singleton term cephalic gestation were studied. Repeated-measures analysis constructed mean labor curves by parity and BMI categories for those who reached 10 cm. Interval-censored regression analysis determined median traverse times, adjusting for covariates in vaginal deliveries and intrapartum cesareans. Results: In the labor curves, the time difference to reach 10 cm was 1.2 hours from the lowest to highest BMI category for nulliparas. Multiparas entered active phase by 6 cm, but reaching this point took longer for BMI <40.0 (3.4 hours) compared to BMI <25.0 (2.4 hours). Progression by centimeter (P <.001 for nulliparas) and from 4-10 cm (P <.001 for nulliparas and multiparas) increased as BMI increased. Second stage length, with and without an epidural, was similar among BMI categories for nulliparas (P >.05) but decreased as BMI increased for multiparas (P <.001). Conclusion: Labor proceeds more slowly as BMI increases, suggesting that labor management be altered to allow longer time for these differences.

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Contemporary labor patterns: The impact of maternal body mass index

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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