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Table 2 Increased intrapartum interventions and increased risk for cesarean delivery for obese parturients

From: Parturition dysfunction in obesity: time to target the pathobiology

Intrapartum intervention Study BMI category Odds of use in labor, OR (95 % CI)
Induction of Labor Scott-Pillai et al., 2013 [142] Overweight 1.2 (1.1-1.3)g, h
Obese 1.3 (1.2-1.5)g, h
Obese II 1.4 (1.3-1.6)g, h
Morbid obese 1.6 (1.3-1.9)g, h
Garabedian et al., 2011 [143] Overweight 1.51 (1.42-1.60)a
Obese 2.00 (1.87-2.15)
Obese II 2.36 (2.16-2.58)
Obese III 3.66 (3.30-4.01)
BMI 40–49.9 3.51 (3.15-3.91)
BMI ≥ 50 5.25 (3.87-7.10)
Bhattacharya et al., 2007 [9] Overweight 1.3 (1.2-1.4)f
Obese 1.8 (1.6-2.0)f
Morbid obese 1.8 (1.3-2.5)f
Artificial Rupture of Membranes prior to 6 cm cervical dilation Jensen, Agger, Rasmussen, 1999 [144] Overweight 1.63 (1.18-2.25)g,b
Obese 1.97 (1.20-3.25)g, b
Oxytocin Augmentation of Labor Garabedian et al., 2011 [143] Overweight 1.38 (1.28-1.49)a
Obese 1.87 (1.70-2.06)
Obese II 2.05 (1.79-2.34)
Obese III 3.02 (2.57-3.55)
BMI 40–49.9 3.00 (2.53-3.56)
BMI ≥ 50 3.21 (1.97-5.23)
  Abenhaim & Benjamin, 2011 [145] Overweight 1.31 (1.15-1.49)g
Obese 1.51 (1.31-1.75)g
Morbid obese 3.05 (1.89-4.94)g
  Vahratian, 2005 [146] Overweight Significantly higher use in both categoriesc
Obese
  Jensen, Agger, Rasmussen, 1999 [144] Overweight 1.59 (1.22-2.06)f, b
Obese 1.98 (1.28-3.05)g, b
Unplanned Cesarean Delivery Vinturache et al., 2014 [147] Overweight  
 Spontaneous labor 1.1 (0.6-1.8)
 Induced labor 1.2 (0.7-2.0)
Obese  
 Spontaneous labor 1.5 (0.7-3.0)
 Induced labor 2.2 (1.2-4.1)f
Scott-Pillai et al., 2013 [142] Overweight 1.4 (1.2-1.5)g, h
Obese 1.6 (1.4-1.8)g, h
Obese II 1.8 (1.5-2.2)g, h
Morbid obese 1.9 (1.4-2.5)g, h
Green & Shaker, 2011 [148] BMI >35 No sig difference once adjusted for IOLc
Garabedian et al., 2011 [143] Overweight 1.44 (1.38-1.50)g
Obese 1.96 (1.86-2.06)g
Obese II 2.32 (2.17-2.47)g
Obese III 3.66 (3.39-3.95)g
BMI 40–49.9 3.53 (3.26-3.82)g
BMI ≥ 50 4.99 (4.00-6.22)g
Abenhaim & Benjamin, 2011 [145] Overweight 1.07 (0.80-1.43)d
Obese
Morbid obese
Cedergren, 2009 [149] Overweight 1.09 (0.91-1.31)
Due to obstructed labor Obese I 1.56 (1.14-2.14)f
Obese II 1.33 (0.72-2.46)
Morbid obese 1.79 (0.65-4.92)
Cedergren, 2009 [149] Overweight 1.50 (1.42-1.59)g
Due to ineffective uterine contractility Obese I 2.14 (1.96-2.34)g
Obese II 2.72 (2.35-3.16)g
Morbid obese 3.98 (3.14-5.04)g
Bhattacharya et al., 2007 [9] Overweigh 1.5 (1.3-1.6)f
Obese 2.0 (1.8-2.3)f
Morbid obese 2.8 (2.0-3.9)f
Sukalich, Mingione, Glantz, 2006 [150] Obese 1.07 (1.05-1.09)f
Vahratian, 2005 [146] Overweight 1.2 (0.8-1.8)f, e
Obese 1.5 (1.05-2.0)f
Jensen, Agger, Rasmussen, 1999 [144] Overweight 1.69 (1.06-2.68)f, b
Obese 1.91 (0.94-3.86)b
  1. Updated from Carlson & Lowe [111]. Odds ratios are for comparison with women of normal BMI
  2. aSignificance not computed
  3. bOR and CIs calculated from frequency tables provided in manuscript
  4. cOR and CI not provided
  5. dNot significant when adjusted for known confounders (maternal age, parity, previous c/s, DM, GDM, hypertension, preeclampsia, cervix on admit, IOL, birthweight, gestational age) and for labor management differences (use of epidural analgesia, oxytocin, forceps, vacuum)
  6. eAdjusted risk ratio reported
  7. fSignificant at p < .05
  8. gSignificant at p < .001
  9. hAdjusted for age, parity, social deprivation, smoking, and year of birth