Volume 3, Issue 3, May 2015, Page: 61-65
Correlation Between Maternal Obesity, Progress of Labour and Risk of Caesarean Delivery in a Cohort of Nigerian Parturients
Ajen Stephen Anzaku, Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Bingham University, Jos Campus, Jos, Nigeria
Adelaiye Samuel Makanjuola, Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Bingham University, Jos Campus, Jos, Nigeria
Yakubu Emmanuel Nyam, Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, Bingham University, Jos Campus, Jos, Nigeria
Utoo Bernard Terkimbi, Department of Obstetrics and Gynaecology, Benue State University Teaching Hospital, Makurdi, Nigeria
Edem Bassey Edet, Department of Anaesthesia, Federal Medical Centre, Makurdi, Nigeria
Received: Apr. 13, 2015;       Accepted: Apr. 27, 2015;       Published: May 11, 2015
DOI: 10.11648/j.jgo.20150303.14      View  3491      Downloads  101
Abstract
Background: Maternal obesity is associated with adverse obstetric outcomes including labour complications.This study aimed at assessing the relationship between maternal obesity and course of first stage of labour and risk of caesarean delivery among women in active first stage of labour. Methods: This retrospective cohort study was a secondary analysis of data collected to assess the impacts of maternal obesity on pregnancy outcomes in a Nigerian obstetric population. We compared progress of labour and risk of caesarean delivery in 170 obese [Body mass index (BMI = ≥ 30 Kg/m2)] and 170 normal weight women (BMI = 18.5 – 24.9 Kg/m2) who were in spontaneous labour at term. They were matched for age and parity and exclusion criteria included women with height less than 1.52 metres, medical disorders, previous caesarean section, those that had augmentation of labour and infant weight > 4.0 Kg. Statistical analysis was done using SPSS version 16 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered significant. Results: Mean age and parity of the women were 30.6 ± 4.8 years and 1.9 ± 1.6 respectively. There was no significant difference between mean cervical dilatation at presentation between the two study groups (4.9 ± 1.8 versus 5.0 ± 1.7, P = 0.64). Cervical dilatation rate per hour was significantly slower in obese group compared to the controls (0.87 ± 0.4 versus 1.2 ± 0.5 cm/hr, P = 0.001). The mean duration of labour was the same in both groups (7.5 ± 3.9 versus 6.2 ± 3.4 hours, P = 0.57). Caesarean section rate increased from 8.8% in the controls to 23.5% among obese women. Obese women had three times higher risk of caesarean delivery compared to the controls (P = 0.002, OR 3.2, 95% CI 1.15 – 8.62) and this was mainly due to failure to progress in labour (P = 0.03). Conclusion: Among women in active phase of labour, maternal obesity was associated with slower rate of cervical dilatation and increased risk of caesarean delivery.
Keywords
Maternal Obesity, Progress of Labour, Caesarean Delivery, Parturient, Nigeria
To cite this article
Ajen Stephen Anzaku, Adelaiye Samuel Makanjuola, Yakubu Emmanuel Nyam, Utoo Bernard Terkimbi, Edem Bassey Edet, Correlation Between Maternal Obesity, Progress of Labour and Risk of Caesarean Delivery in a Cohort of Nigerian Parturients, Journal of Gynecology and Obstetrics. Vol. 3, No. 3, 2015, pp. 61-65. doi: 10.11648/j.jgo.20150303.14
Reference
[1]
BaetenJM, BukusiEA, Lambe M. Pregnancy complications and outcomes among overweight and obese women. Am J Public Health 2001; 91: 436 – 40.
[2]
Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008; 9: 635 – 83.
[3]
NohrEA, BechBH, Davies MJ, Frydenberg M, Henriksen TB, Olsen J. Prepregnancy obesity and fetal death: a study within the Danish National Birth Cohort. ObstetGynecol 2005; 106: 250 – 9.
[4]
Ramsay JE, Greer I, Sattar N. ABC of obesity. Obesity and reproduction. BMJ 2006; 333: 1159 – 62.
[5]
Cogswell ME, Perry GS, Schieve LA, Dietz WH. Obesity in women of childbearing age: risks, prevention, and treatment. Prim Care Update Ob Gyns 2001; 8: 89 – 105.
[6]
Kanaglingam MG, Forouhi NG, Greer IA, Sattar N. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. BJOG 2005; 112: 1431 – 3.
[7]
Anzaku AS, Achara AP, Akaba GO, Yakubu EN. Prevalence and Risk Factors for Obesity in a Nigerian Obstetric Population. American Journal of Health Research 2014; 5: 229 – 233.
[8]
Kaiser PS, Kirby RS. Obesity as a risk factor for cesarean in a low risk population. ObstetGynecol 2001; 97: 39 – 43.
[9]
Young TK, Woodmansee B. Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J ObstetGynecol 2002; 187: 312 – 20.
[10]
PerlowJH, Morgan MA, Montgomery D, Towers CV, Porto M. Perinatal outcome in pregnancy complicated by massive obesity. Am J ObstetGynecol 1992; 167: 968–72.
[11]
Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. ObstetGynecol 2004; 103: 219 – 24.
[12]
Khashan AS, Kenny LC. The effects of maternal body mass index on pregnancy outcome. Eur J Epidemiol 2009; 24: 697 – 705.
[13]
Roman H, Goffinet F, Hulsey TF, Newman R, RobillardPY, Hulsey TC. Maternal body mass index at delivery and risk of caesarean due to dystocia in low risk pregnancies. ActaObstetGynecol 2008; 87: 163–70.
[14]
Sheiner E, Levy A, Menes TS, Silverberg D, Katz M, Mazor M. Maternal obesity as an independent risk factor for caesarean delivery. PaedPerinatEpidemiol 2004; 18: 196–201.
[15]
Jensen H, Agger AO, Rasmussen KL. The influence of prepregnancy body mass index on labor complications. ActaObstetGynecolScand 1999; 78: 799 – 802.
[16]
Ehrenberg HM, Huston-Presley L, Catalano PM. The influence of obesity and gestational diabetes mellitus on accretion and the distribution of adipose tissue in pregnancy. Am J ObstetGynecol 2003; 189: 944 – 8.
[17]
Norman SM, Tuuli MG, Odibo AO, Caughhey AB, Roehl KA, Cahill AG. The effects of obesity on the first stage of labor. ObstetGynecol 2012; 120: 130 – 5.
[18]
Kominiarek MA, Zhang J, van Veldhuisen P, Troendle J, Beaver J, Hibbard JU. Contemporary labour pattern: the impact of maternal body mass index. Am J ObstetGynecol 2011; 205: 244 – 8.
[19]
Verdiales M, Pacheco C, Cohen WR. The effect of maternal obesity on the course of labor. J Perinat Med 2009; 37: 651 – 5.
[20]
NuthalapatyFS, Rouse DJ, Owen J. The association of maternal weight with cesarean risk, labor duration, and cervical dilatation rate during labour induction. ObstetGynecol 2004; 103: 452 – 6.
[21]
Zhang J, Bricker L, Wray S, Quenby S. Poor uterine contractility in obese women. Br J ObstetGynaecol 2007; 114: 343 – 8.
[22]
Caughey AB, Stotland NE, Washington AE, Escobar GJ. Who is at risk for prolonged and postterm pregnancy? Am J ObstetGynecol 2009; 200: 683 – 5.
[23]
Denilson FC, Price J, Graham C, Wild S, Liston WA. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labor at term. Br J ObstetGynaecol 2008; 115: 720 – 5.
[24]
Moynihan AT, Hehir MP, GlaveySV, Smith TJ, Morrison JJ. Inhibitory effect of leptin on human uterine contractility in vitro. Am J ObstetGynecol 2006; 196: 504 – 9.
[25]
Zhang J, Kendrick A, Quenby S, Wray S. Contactility and calcium signaling of human myometrium are profoundly affected by cholesterol manipulation: implication for labor?ReprodSci 2007: 14: 456 – 66.
[26]
Laraia BA, Siege-Riz AM, Dole N, London E. Pregravid weight is associated with prior dietary restraint and psychological factors during pregnancy. Obesity 2009; 17: 550 – 8.
[27]
Lowe NK, Corwin EJ. Proposed biological linkages between obesity, stress and inefficient uterine contractility during labour in humans. Medical Hypothesis 2011; 76: 755 – 60.
[28]
Pevzner L, Powers BL, Rayburn WF, Rumney P, Wing DA. Effects of maternal obesity on duration and outcomes of prostaglandin cervical ripening and labor indction. ObstetGynecol 2009; 114: 1315 – 21.
[29]
Cedergren MI. Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index. Eur J ObstetGynecolReprodBiol 2009; 145; 163 – 6.
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