title: Labor length among overweight and obese women undergoing induction of labor.
abstract: OBJECTIVE
  Maternal weight is thought to impact labor. With rising rates of obesity and inductions, we sought to evaluate labor times among induced women by body mass index (BMI) category.
  
  
  METHODS
  Retrospective cohort study of term inductions from 2005 to 2010. BMI categories were: normal weight (NW), overweight (OW), and obese (Ob) (18.5-24.9, 25-29.9, ≥30 kg/m(2)). Kruskal-Wallis tests compared median latent labor (LL) length and active labor (AL) length. Chi-square determined associations. Multivariable logistic regression controlled for confounders. Analyses were stratified by parity.
  
  
  RESULTS
  A total of 448 inductions were analyzed. For nulliparas, there was no difference in LL by BMI category (p = 0.22). However, OW nulliparas had a longer AL compared to NW and Ob nulliparas (3.2, 1.7, 2.0 h, p = 0.005). For multiparas, NW had the shortest LL (5.5 h, p = 0.025) with no difference in AL among BMI categories (p = 0.42). The overall cesarean rate was 23% with no difference by BMI category (p = 0.95). However, Ob women had a greater percentage of first stage cesareans (41%) and NW had a greater percentage of second stage cesareans (55%), p = 0.06.
  
  
  CONCLUSIONS
  The association between BMI and labor length among inductions differs by phase of labor and parity. BMI also influences the stage of labor in which a cesarean occurs.
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA , USA.
authors.forename: Adi
authors.initials: A
authors.lastname: Hirshberg
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Levine
authors.forename: Sindhu
authors.initials: S
authors.lastname: Srinivas
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data*; D007743:Labor, Obstetric / Q000502:physiology*; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Body mass index; induction of labor; labor curves; labor length; obesity