Open AccessRisk factors for failed induction of labor among pregnant women with Class III obesity
Author(s) -
Kerbage Yohan,
Senat Marie V.,
Drumez Elodie,
Subtil Damien,
Vayssiere Christophe,
Deruelle Philippe
Publication year - 2020
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13794
Subject(s) - medicine , interquartile range , odds ratio , obstetrics , pregnancy , confidence interval , birth weight , body mass index , retrospective cohort study , apgar score , cohort study , risk factor , gynecology , genetics , biology
Our aim was to identify risk factors for failed induction in morbidly obese patients undergoing the induction of labor at term. Material and methods This was a retrospective multicenter study on a cohort of 235 patients with a body mass index greater than 40 kg/m 2 and giving birth to a singleton in cephalic presentation, who had an induction of labor from 38 weeks of amenorrhea. Scheduled cesareans and spontaneous vaginal deliveries were excluded. Maternal, peri‐partum and neonatal characteristics were analyzed according to the delivery route. Results In all, 235 patients were included. Of these, 62.5% patients delivered vaginally and 37.5% by cesarean section. The frequency of nulliparity was greater in patients who had a cesarean section (56 [interquartile range, IQR, 38.1] vs 56 [IQR 63.6], P < .001). In multivariate analysis, nulliparity (odds ratio [OR] 2.81, 95% confidence interval [CI] 1.58‐4.97], P < .001), low Bishop’s score (OR .794, 95% CI .70‐.90, P < .001) and weight gain (OR 1.04, 95% CI 1.01‐1.08, P = .033) were independent risk factors for failed induction. Umbilical cord pH at birth lower than 7 (0 vs 7 [IQR 8.0], P < .001) and lower than 7.20 (36 [IQR 24.5] vs 35 [IQR 39.8], P = .014) as well as the Apgar at 1 minute (14 [IQR 9.5] vs 17 [IQR 19.3], P = .032) was significantly higher in infants born by cesarean section. Conclusions In this cohort, 63% of women with Class III obesity had successful inductions of labor; risk factors for failed induction include nulliparity and unfavorable Bishop score.