Contemporary labor patterns: the impact of maternal body mass index

被引：146

作者：

Kominiarek, Michelle A. ^{[1
,2
]}

Zhang, Jun ^{[3
]}

VanVeldhuisen, Paul ^{[5
]}

Troendle, James ^{[4
]}

Beaver, Julie

Hibbard, Judith U. ^{[1
]}

机构：

[1] Univ Illinois, Dept Obstet & Gynecol, Div Maternal Fetal Med, Chicago, IL 60612 USA

[2] Indiana Univ Sch Med Clarian Hlth, Dept Obstet & Gynecol, Div Maternal Fetal Med, Indianapolis, IN USA

[3] Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Shanghai Key Lab Childrens Environm Hlth, Shanghai 200030, Peoples R China

[4] NHLBI, Div Cardiovasc Sci, NIH, Bethesda, MD 20892 USA

[5] EMMES Corp, Rockville, MD USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2011年 / 205卷 / 03期

关键词：

body mass index; labor curves; obesity; pregnancy; CESAREAN DELIVERY; OBESITY; RISK; PROGRESSION; WEIGHT; CONTRACTILITY; ASSOCIATION; PREGNANCY; DURATION; OUTCOMES;

D O I：

10.1016/j.ajog.2011.06.014

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

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.

引用

页数：8

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