title: Examining the effect of maternal obesity on outcome of labor induction in patients with preeclampsia.
abstract: OBJECTIVE
  The objective of this investigation was to evaluate the effect of maternal obesity, as measured by prepregnancy body mass index (BMI), on the mode of delivery in women undergoing indicated induction of labor for preeclampsia.
  
  
  METHODS
  Following Institutional Review Board (IRB) approval, patients with preeclampsia who underwent an induction of labor from 1997 to 2007 were identified from a perinatal information database, which included historical and clinical information. Data analysis included bivariable and multivariable analyses of predictor variables by mode of delivery. An artificial neural network was trained and externally validated to independently examine predictors of mode of delivery among women with preeclampsia.
  
  
  RESULTS
  Six hundred and eight women met eligibility criteria and were included in this investigation. Based on multivariable logistic regression (MLR) modeling, a 5-unit increase in BMI yields a 16% increase in the odds of cesarean delivery. An artificial neural network trained and externally validated confirmed the importance of obesity in the prediction of mode of delivery among women undergoing labor induction for preeclampsia.
  
  
  CONCLUSIONS
  Among patients who are affected by preeclampsia, obesity complicates labor induction. The risk of cesarean delivery is enhanced by obesity, even with small increases in BMI. Prediction of mode of delivery by an artificial neural network performs similar to MLR among patients undergoing labor induction for preeclampsia.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. robinscj@musc.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Robinson
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Hill
authors.forename: Mark C
authors.initials: MC
authors.lastname: Alanis
authors.forename: Eugene Y
authors.initials: EY
authors.lastname: Chang
authors.forename: Donna D
authors.initials: DD
authors.lastname: Johnson
authors.forename: Jonas S
authors.initials: JS
authors.lastname: Almeida
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007751:Labor, Induced; D009765:Obesity; D011225:Pre-Eclampsia; D011247:Pregnancy; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
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