title: [Predictors of failed trial of labor in obese nulliparous].
abstract: OBJECTIVE
  To identify predictors of failed trial of labour (TOL) in obese nulliparous at term.
  
  
  METHODS
  Retrospective study about 213 nulliparous with a body mass index (BMI) greater than 30kg/m(2) who delivered a vertex singleton after 37 weeks of gestation (WG). Planned caesarean sections were excluded. Maternal, sonographic, per-partum and neonatal characteristics were analyzed according to the mode of entry into labor and delivery route. Univariate and multivariate logistic regression analysis were performed.
  
  
  RESULTS
  The cesarean delivery rate was 28%. Induction of labor (aOR=4.3 [1.8-10.7]), prolonged pregnancy (aOR=10.8 [1.7-67.6]), macrosomia (aOR=5.6 [1.1-27.3]), meconium-stained amniotic fluid (aOR: 2.57 [1.03-6.42]), use of trinitrine (aOR=5.5 [1.39-21.6]) and neonatal head circumference greater than 35cm (aOR=3.1 [1.2-8.0]) were predictors of failed TOL. There was no significant correlation between failed TOL and preconceptional BMI. Univariate analysis revealed an association between excessive weight gain and failed TOL.
  
  
  CONCLUSIONS
  Predictors of failed TOL are the same in obese and non-obese women. Preconceptional BMI does not predict failed TOL in this nulliparous obese population.
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: A
authors.initials: A
authors.lastname: Carassou-Maillan
authors.affiliation: Département d'information médicale, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
authors.forename: A
authors.initials: A
authors.lastname: Mulliez
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: S
authors.initials: S
authors.lastname: Curinier
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Houlle
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Canis
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: D
authors.initials: D
authors.lastname: Lemery
authors.affiliation: Pôle gynéco-obstétrique-reproduction humaine, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand cedex 1, France; R2D2-EA7281, faculté de médecine, université d'Auvergne, place Henri-Dunant, 63000 Clermont-Ferrand, France. Electronic address: dgallot@chu-clermontferrand.fr.
authors.forename: D
authors.initials: D
authors.lastname: Gallot
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005320:Fetal Macrosomia; D005865:Gestational Age; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data; D009765:Obesity / Q000150:complications*; D010298:Parity / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D014219:Trial of Labor; D015430:Weight Gain
keywords: Accouchement; Cesarean delivery; Césarienne non programmée; Facteurs prédictifs; Intention de voie basse; Maternal obesity; Nulliparous; Obésité maternelle; Parturition; Predictors; Primipare; Trial of labor