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

Research output: Contribution to journalArticle

94 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)244.e1-244.e8
JournalAmerican journal of obstetrics and gynecology
Volume205
Issue number3
DOIs
StatePublished - Jan 1 2011

Fingerprint

Body Mass Index
Mothers
Parity
Head
Regression Analysis
Pregnancy

Keywords

  • body mass index
  • labor curves
  • obesity
  • pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Kominiarek, Michelle A. ; Zhang, Jun ; Vanveldhuisen, Paul ; Troendle, James ; Beaver, Julie ; Hibbard, Judith U. / Contemporary labor patterns : The impact of maternal body mass index. In: American journal of obstetrics and gynecology. 2011 ; Vol. 205, No. 3. pp. 244.e1-244.e8.
@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.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1016/j.ajog.2011.06.014",
language = "English (US)",
volume = "205",
pages = "244.e1--244.e8",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

Kominiarek, MA, Zhang, J, Vanveldhuisen, P, Troendle, J, Beaver, J & Hibbard, JU 2011, 'Contemporary labor patterns: The impact of maternal body mass index', American journal of obstetrics and gynecology, vol. 205, no. 3, pp. 244.e1-244.e8. https://doi.org/10.1016/j.ajog.2011.06.014

Contemporary labor patterns : The impact of maternal body mass index. / Kominiarek, Michelle A.; Zhang, Jun; Vanveldhuisen, Paul; Troendle, James; Beaver, Julie; Hibbard, Judith U.

In: American journal of obstetrics and gynecology, Vol. 205, No. 3, 01.01.2011, p. 244.e1-244.e8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Contemporary labor patterns

T2 - The impact of maternal body mass index

AU - Kominiarek, Michelle A.

AU - Zhang, Jun

AU - Vanveldhuisen, Paul

AU - Troendle, James

AU - Beaver, Julie

AU - Hibbard, Judith U.

PY - 2011/1/1

Y1 - 2011/1/1

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.

AB - 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.

KW - body mass index

KW - labor curves

KW - obesity

KW - pregnancy

UR - http://www.scopus.com/inward/record.url?scp=80052261835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052261835&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2011.06.014

DO - 10.1016/j.ajog.2011.06.014

M3 - Article

C2 - 21798510

AN - SCOPUS:80052261835

VL - 205

SP - 244.e1-244.e8

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 3

ER -