title: Birth complications, overweight, and physical inactivity.
abstract: OBJECTIVE
  Maternal lifestyle factors are potential predictors of pregnancy complications. We examined relations between modifiable factors and delivery complications.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  University hospital antenatal clinic, Oslo, Norway.
  
  
  METHODS
  A cohort of 553 women followed through pregnancy and delivery.
  
  
  METHODS
  Pre-specified birth complications: cesarean section (CS), operative vaginal deliveries (VDs), third and fourth degree of perineal lacerations and hemorrhage (> or =1,000 ml).
  
  
  METHODS
  Univariate and multiple logistic regression analyses were performed. Besides high birthweight (> or =4,200 g), modifiable predictors (high body mass index (BMI), fasting glucose and physical inactivity) and non-modifiable predictors (parity, maternal age, gestational age, and gender) were considered.
  
  
  RESULTS
  Significant predictors for induction of labor were parity (odds ratio (OR): 2.1; 95% CI 1.3-3.5), maternal age (OR: 2.0; 1.2-3.4), gestational age (OR: 1.9; 1.1-3.1), and BMI > or =30 (OR: 4.2; 2.2-7.8, p<0.01). High birthweight and high BMI were overrepresented among CSs. Emergency CS was associated with birthweight (OR: 3.7; 1.7-8.1), parity (OR: 3.5; 1.7-7.2), maternal age (OR: 2.6; 1.3-5.3), and induction of labor (OR: 4.8; 2.6-9.1). After excluding CS, operative VD was associated with parity (OR: 8.7; 3.8-20) and gender (OR: 2.2; 1.2-14.1). Perineal laceration was associated with pre-gestational physical inactivity (OR: 6.1; 1.6-22.9) and operative VD (OR: 5.1; 1.5-17.6). Hemorrhage was associated with high birthweight (OR: 4.2; 1.2-4.7) and BMI > or =30 (OR: 4.6; 1.2-17.7).
  
  
  CONCLUSIONS
  Pre-gestational physical inactivity increased the risk of perineal lacerations and male infants were associated with higher risk of vaginal operative delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Rikshospitalet University Hospital, University of Oslo, Oslo, Norway. nanna.voldner@rikshospitalet.no
authors.forename: Nanna
authors.initials: N
authors.lastname: Voldner
authors.forename: Kathrine Frey
authors.initials: KF
authors.lastname: Frøslie
authors.forename: Lene Anette Hagen
authors.initials: LA
authors.lastname: Haakstad
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.forename: Tore
authors.initials: T
authors.lastname: Henriksen
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015601:Injury Severity Score; D007751:Labor, Induced; D022125:Lacerations / Q000453:epidemiology*; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D009765:Obesity / Q000150:complications*; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose