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Predictors of failed trial of labor among women with an extremely obese body mass index.

Publication ,  Journal Article
Gunatilake, RP; Smrtka, MP; Harris, B; Kraus, DM; Small, MJ; Grotegut, CA; Brown, HL
Published in: Am J Obstet Gynecol
December 2013

OBJECTIVE: The purpose of this study was to examine predictors associated with cesarean delivery (CD) among extremely obese women undergoing a trial of labor (TOL). STUDY DESIGN: Using a delivery database, we identified all pregnant women delivering at our institution from Jan. 1, 2008, through July 31, 2010, weighing >275 lb at the time of delivery who attempted a TOL with a singleton gestation >34 weeks' gestation. Demographic and obstetrical factors were compared for those having a successful vaginal delivery to those having a CD. RESULTS: During the study period, there were 357 pregnant women who weighed >275 lb (all with body mass index [BMI] >40 kg/m(2)), and among these, 248 (69.5%) attempted a TOL. Women having a CD had a greater BMI (51.6 vs 49.9 kg/m(2), P = .038), were less likely to be parous (32.2% vs 65.8%, P < .0001), and were more likely to be induced (80.5% vs 57.8%) compared to those having a vaginal delivery. Using a multivariable logistic regression model, among nulliparous women, maternal age, parity, and cervical dilation at time of admission were independent predictors for CD. Furthermore, an increase in BMI of 10 kg/m(2) was associated with a 3.5 increased odds (P = .002) for CD. CONCLUSION: Among nulliparous extremely obese women attempting a TOL, BMI was an independent predictor of CD, with the rate of CD increasing further with increasing BMI. The underlying mechanisms for failed TOL in the setting of maternal obesity remain largely unknown.

Duke Scholars

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2013

Volume

209

Issue

6

Start / End Page

562.e1 / 562.e5

Location

United States

Related Subject Headings

  • Trial of Labor
  • Risk Factors
  • Pregnancy Complications
  • Pregnancy
  • Parity
  • Obstetrics & Reproductive Medicine
  • Obesity
  • North Carolina
  • Logistic Models
  • Labor, Induced
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gunatilake, R. P., Smrtka, M. P., Harris, B., Kraus, D. M., Small, M. J., Grotegut, C. A., & Brown, H. L. (2013). Predictors of failed trial of labor among women with an extremely obese body mass index. Am J Obstet Gynecol, 209(6), 562.e1-562.e5. https://doi.org/10.1016/j.ajog.2013.07.023
Gunatilake, Ravindu P., Michael P. Smrtka, Benjamin Harris, Daniel M. Kraus, Maria J. Small, Chad A. Grotegut, and Haywood L. Brown. “Predictors of failed trial of labor among women with an extremely obese body mass index.Am J Obstet Gynecol 209, no. 6 (December 2013): 562.e1-562.e5. https://doi.org/10.1016/j.ajog.2013.07.023.
Gunatilake RP, Smrtka MP, Harris B, Kraus DM, Small MJ, Grotegut CA, et al. Predictors of failed trial of labor among women with an extremely obese body mass index. Am J Obstet Gynecol. 2013 Dec;209(6):562.e1-562.e5.
Gunatilake, Ravindu P., et al. “Predictors of failed trial of labor among women with an extremely obese body mass index.Am J Obstet Gynecol, vol. 209, no. 6, Dec. 2013, pp. 562.e1-562.e5. Pubmed, doi:10.1016/j.ajog.2013.07.023.
Gunatilake RP, Smrtka MP, Harris B, Kraus DM, Small MJ, Grotegut CA, Brown HL. Predictors of failed trial of labor among women with an extremely obese body mass index. Am J Obstet Gynecol. 2013 Dec;209(6):562.e1-562.e5.
Journal cover image

Published In

Am J Obstet Gynecol

DOI

EISSN

1097-6868

Publication Date

December 2013

Volume

209

Issue

6

Start / End Page

562.e1 / 562.e5

Location

United States

Related Subject Headings

  • Trial of Labor
  • Risk Factors
  • Pregnancy Complications
  • Pregnancy
  • Parity
  • Obstetrics & Reproductive Medicine
  • Obesity
  • North Carolina
  • Logistic Models
  • Labor, Induced