E-ISSN: 2619-9467

Contents    Cover    Publication Date: 19 Dec 2019
Year 2019 - Volume 29 - Issue 4

Open Access

Peer Reviewed

ORIGINAL RESEARCH
2352 Viewed883 Downloaded

The Effects of Gestational Weight Gain and Maternal Body Mass Index Discrepancy on All Stages of Labor

Full Text PDF  
J Clin Obstet Gynecol. 2019;29(4):141-7
DOI: 10.5336/jcog.2019-71902
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To investigate the effects of maternal body mass index (BMI) and total weight gain during the pregnancy (WGDP) on all stages of labor. Material and Methods: This is a prospective case-control study carried out at a tertiary referral hospital during 1-year period of time. We divided study population into 4 groups according to BMI and classified women according to WGDP; inadequate, optimum, excessive. Then we assessed the maternal characteristics, cesarean rate, all variables of labor stages, delivery complications, operative delivery rates, and interventions such as; induction rate and episiotomy. Results: A total of 523 women were included in the study [n=55 (10.5%) cesarean section and n=468 (89.5%) vaginal delivery]. There were 435 pregnant Turkish women and 88 Syrian Refugees in the study population. Younger maternal age and need for episiotomy was more common in low-weight group than others. All stages of labor except transition stages (duration between 7 and 10 cm of cervical dilatation) was longer in obese group (222.9±35.6 min, 195.8±29.6 min, 200.6±30.4 min, 255.8±38.2 min in group 1,2,3 and 4, respectively) (p<0.05). We found no statistically significant effect of weight gain on the duration of labor. Conclusion: Either low and high pre-gestational BMI are found to lead to increased risk of adverse labor results in compatible with literature. Therefore, professionals should support weight loss or gain to achieve optimal BMI in women planning pregnancy.
REFERENCES:
  1. Fisher SC, Kim SY, Sharma AJ, Rochat R, Morrow B. Is obesity still increasing among pregnant women? Prepregnancy obesity trends in 20 states, 2003-2009. Prev Med. 2013;56(6):372-8. [Crossref] [PubMed] [PMC]
  2. World Health Organization (WHO). Global Health Observatory Data Repository. Available at: http://apps.who.int/gho/data/node.main.A903?lang=en. Accessed 6 Nov 2014.
  3. Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight-48 States, New York City, and District of Columbia, 2011-2015. MMWR Morb Mortal Wkly Rep. 2018;66(5152):1402-7. [Crossref] [PubMed] [PMC]
  4. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103(2):219-24. [Crossref] [PubMed]
  5. Ellekjaer KL, Bergholt T, Løkkegaard E. Maternal obesity and its effect on labour duration in nulliparous women: a retrospective observational cohort study. BMC Pregnancy Childbirth. 2017;17(1):222. [Crossref] [PubMed] [PMC]
  6. Institute of Medicine, Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I, Weight Gain: Part II, Nutrient Supplements. 1st ed. Washington, D.C: National Academy Press; 1990. p.480.
  7. Maged AM, Belal DS, Marie HM, Rashwan H, Abdelaziz S, Gabr AA, et al. Prospective study of the effect of maternal body mass index on labor progress in nulliparous women in Egypt. Int J Gynecol Obstet. 2017;139(3):329-35. [Crossref] [PubMed]
  8. Liu P, Xu L, Wang Y, Zhang Y, Du Y, Sun Y, et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index. Obes Rev. 2016;17(11):1091-102. [Crossref] [PubMed]
  9. Davies GAL, Maxwell C, McLeod L. Obesity in pregnancy. J Obstet Gynaecol Can. 2010;32(2):165-73. [PubMed]
  10. Bergholt T, Lim LK, Jørgensen JS, Robson MS. Maternal body mass index in the first trimester and risk of caesarean delivery in nulliparous women in spontaneous labour. Am J Obstet Gynecol. 2007;196(2):163.e1-5. [Crossref] [PubMed]
  11. Usha Kiran TS, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG. 2005;112(6):768-72. [Crossref] [PubMed]
  12. Carlhäll S, Källén K, Blomberg M. Maternal body mass index and duration of labor. Eur J Obstet Gynecol Reprod Biol. 2013;171(1):49-53. [Crossref] [PubMed]
  13. Norman SM, Tuuli MG, Odibo AO, Caughey AB, Roehl KA, Cahill AG. The effects of obesity on the first stage of labour. Obstet Gynecol. 2012;120(1):130-5. [Crossref] [PubMed] [PMC]
  14. Kominiarek MA, Zhang J, Vanveldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labor patterns: the impact of maternal body mass index. Am J Obstet Gynecol. 2011;205(3):244.e1-8. [Crossref] [PubMed] [PMC]
  15. Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AM. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol. 2004;104(5 Pt 1):943-51. [Crossref] [PubMed]
  16. Hilliard AM, Chauhan SP, Zhao Y, Rankins NC. Effect of obesity on length of labor in nulliparous women. Am J Perinatol. 2012;29(02):127-32. [Crossref] [PubMed]
  17. Pevzner L, Powers BL, Rayburn WF, Rumney P, Wing DA. Effects of maternal obesity on duration and outcomes of prostaglandin cervical ripening and labor induction. Obstet Gynecol. 2009;114(6):1315-21. [Crossref] [PubMed]
  18. Stothard KJ, Tennant PW, Bell R, Rankin J. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009;301(6):636-50. [Crossref] [PubMed]
  19. Persson M, Johansson S, Villamor E, Cnattingius S. Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort study in Sweden. PLoS Med. 2014;11(5):e1001648. [Crossref] [PubMed] [PMC]
  20. Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA. 2014;311(15):1536-46. [Crossref] [PubMed]
  21. Lu GC, Rouse DJ, DuBard M, Cliver S, Kimberlin D, Hauth JC. The effect of the increasing prevalence of maternal obesity on perinatal morbidity. Am J Obstet Gynecol. 2001;185(4):845-9. [Crossref] [PubMed]
  22. Aviram A, Yogev Y, Bardin R, Hiersch L, Wiznitzer A, Hadar E. Association between sonographic measurement of fetal head circumference and labor outcome. Int J Gynecol Obstet. 2016;132(1):72-6. [Crossref] [PubMed]