title: Factors influencing maternal perception of uterine contractions.
abstract: OBJECTIVE
  The purpose of this study was to assess factors associated with perception of uterine contractions.
  
  
  METHODS
  A database of ambulatory uterine activity monitoring was examined. All patients having singleton pregnancies evaluated between March 1997 and March 2002 were eligible for analysis. Data were divided into 4 groups by maternal prepregnancy body mass index (BMI): lean (<20 kg/m(2)), normal (>or=20 to <25 kg/m(2)), overweight (>or=25 to <30 kg/m(2)), and obese (>or=30 kg/m(2)). The percentage of contractions perceived during observation was compared between groups. Variables interrogated included maternal weight and parity. Statistical analysis included t test, analysis of variance (ANOVA), and linear regression.
  
  
  RESULTS
  Data from 7808 patients (556,382 hr) were analyzed. A significant reduction in perception of contractions occurred with increasing BMI between each classification, P <.001. A significant reduction in perception of contractions was also noted between nulliparous and multiparous patients at each weight classification, P <.001.
  
  
  CONCLUSIONS
  Obese, nulliparous patients have the greatest difficulty perceiving contractions. Such data may help explain unattended birth or late presentation for care in this group.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kentucky, Central Baptist Hospital, Lexington, Kentucky, USA.
authors.forename: Hope M
authors.initials: HM
authors.lastname: Cottrill
authors.forename: John R
authors.initials: JR
authors.lastname: Barton
authors.forename: John M
authors.initials: JM
authors.lastname: O'brien
authors.forename: Debbie L
authors.initials: DL
authors.lastname: Rhea
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Milligan
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008423:Maternal Age; D010298:Parity; D010465:Perception / Q000502:physiology*; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013851:Thinness; D014590:Uterine Contraction / Q000502:physiology*; D018590:Uterine Monitoring / Q000379:methods*