title: Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study.
abstract: OBJECTIVE
  To compare perinatal outcomes between elective induction of labour (eIOL) and expectant management in obese women.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Deliveries in California in 2007.
  
  
  METHODS
  Term, singleton, vertex, nonanomalous deliveries among obese women (n = 74 725).
  
  
  METHODS
  Women who underwent eIOL at 37 weeks were compared with women who were expectantly managed at that gestational age. Similar comparisons were made at 38, 39, and 40 weeks. Results were stratified by parity. Chi-square tests and multivariable logistic regression were used for statistical comparison.
  
  
  METHODS
  Method of delivery, severe perineal lacerations, postpartum haemorrhage, chorioamnionitis, macrosomia, shoulder dystocia, brachial plexus injury, respiratory distress syndrome.
  
  
  RESULTS
  The odds of caesarean delivery were lower among nulliparous women with eIOL at 37 weeks [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.34-0.90] and 39 weeks (OR 0.77, 95% CI 0.63-0.95) compared to expectant management. Among multiparous women with a prior vaginal delivery, eIOL at 37 (OR 0.39, 95% CI 0.24-0.64), 38 (OR 0.65, 95% CI 0.51-0.82), and 39 weeks (OR 0.67, 95% CI 0.56-0.81) was associated with lower odds of caesarean. Additionally, eIOL at 38, 39, and 40 weeks was associated with lower odds of macrosomia. There were no differences in the odds of operative vaginal delivery, lacerations, brachial plexus injury or respiratory distress syndrome.
  
  
  CONCLUSIONS
  In obese women, term eIOL may decrease the risk of caesarean delivery, particularly in multiparas, without increasing the risks of other adverse outcomes when compared with expectant management.
authors: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
authors: V R
authors: VR
authors: Lee
authors: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.|National Public Health Institute, Cuernvaca, Mexico.
authors: B G
authors: BG
authors: Darney
authors: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.|Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR, USA.
authors: J M
authors: JM
authors: Snowden
authors: California Pacific Medical Center, San Francisco, CA, USA.
authors: E K
authors: EK
authors: Main
authors: Sutter Health System, Sacramento, CA, USA.
authors: W
authors: W
authors: Gilbert
authors: University of California, Irvine, CA, USA.
authors: J
authors: J
authors: Chung
authors: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
authors: A B
authors: AB
authors: Caughey
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004420:Dystocia / Q000453:epidemiology*; D017558:Elective Surgical Procedures / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000523:psychology / Q000706:statistics & numerical data*; D016015:Logistic Models; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Caesarean delivery; elective induction of labour; maternal obesity