Table 2.
Attempted assisted vaginal delivery in relation to pre-pregnancy body weight and participant characteristics among laboring women in need of operative delivery assistance (N = 2282). Percentage represents the total number for each category in the final study group
| Characteristics | Attempted vacuum | Attempted Forceps | ||||
|---|---|---|---|---|---|---|
| N (%) | Crude OR [95% CI] | Adjusted OR [95% CI] | N (%) | Crude OR [95% CI] | Adjusted OR [95% CI] | |
| Pre-pregnancy BMI (kg/m2) | ||||||
| Normal Weight (18.5 to < 23.0) | 777 (37.7) | Reference | Reference | 623 (30.2) | Reference | Reference |
| Overweight (23.0–27.5) | 145 (40.2) | 0.87 [0.72–0.99] | 0.88 [0.69–0.98] | 131 (36.3) | 0.79 [0.69–0.99] | 0.76 [0.68–0.98] |
| Obese (≥27.5) | 304 (48.3) | 0.43 [0.36–0.67]* | 0.42 [0.32–0.72]* | 302 (48.1) | 0.38 [0.31–0.59]* | 0.34 [0.29–0.52]* |
| Age (years) | ||||||
| < 20 years | 88 (39.6) | 1.08 [1.02–1.14] | 1.15 [1.08–1.44] | 78 (35.1) | 0.99 [0.87–1.13] | 1.08 [0.98–1.13] |
| 20–24 years | 202 (40.6) | Reference | Reference | 174 (35.8) | Reference | Reference |
| 25–29 years | 354 (40.4) | 0.99 [0.84–1.20] | 0.97 [0.79–1.31] | 305 (34.8) | 0.92 [0.76–1.10] | 0.93 [0.85–1.03] |
| 30–35 years | 368 (40.3) | 0.88 [0.69–1.14] | 0.89 [0.74–1.12] | 315 (34.5) | 0.89 [0.79–1.09] | 0.88 [0.77–1.12] |
| > 35 years | 214 (39.8) | 0.98 [0.77–1.31] | 0.98 [0.79–1.18] | 184 (34.4) | 0.99 [0.84–1.03] | 0.98 [0.85–1.09] |
| Smoking Cigarettes | ||||||
| No smoking | 1135 (40.7) | 0.98 [0.66–1.24] | 969 (34.9) | 0.89 [0.67–1.16] | ||
| Smoking | 91 (34.8) | Reference | 87 (32.5) | Reference | ||
| Diabetes (Type 1, 2, GDM) | ||||||
| Not Diabetes | 1128 (39.7) | Reference | Reference | 981 (34..6) | Reference | Reference |
| Diabetes | 98 (50.5) | 0.51 [0.33–0.75]* | 0.55 [0.35–0.88]* | 75 (38.6) | 0.68 [0.56–0.78]* | 0.64 [0.54–0.76]* |
| Hypertension (chronic, pregnancy-induced, preeclampsia) | ||||||
| Not hypertension | 1150 (37.7) | Reference | 987 (40.6) | Reference | ||
| Hypertension | 79 (38.3) | 0.88 [0.62–1.15] | 74 (37.2) | 0.83 [0.61–1.16] | ||
| Received Prenatal care | ||||||
| No | 17 (45.0) | 1.48 [0.44–4.09] | 19 (39.0) | 1.48 [0.49–5.01] | ||
| Yes | 1212 (40.2) | Reference | 1042 (38.2) | Reference | ||
| Induction | ||||||
| No | 401 (44.7) | Reference | Reference | 304 (34.2) | Reference | Reference |
| Yes | 828 (54.9) | 1.61 [1.08–2.81]* | 1.77 [1.00–2.87]* | 757 (45.5) | 1.63 [1.08–2.83]* | 1.71 [1.00–2.87]* |
| Epidural Anesthesia | ||||||
| No | 205 (15.5) | Reference | Reference | 135 (10.7) | Reference | Reference |
| Yes | 1024 (30.9) | 1.26 [0.86–1.68]* | 1.62 [1.12–2.39]* | 926 (28.6) | 1.31 [0.96–1.78]* | 1.78 [1.02–2.44]* |
| Adherence to 2009 IOM guideline | ||||||
| Inadequate | 108 (88.3) | 1.65 [1.10–2.41]* | 1.81 [1.15–2.83]* | 87 (88.1) | 1.69 [1.10–2.53]* | 1.88 [1.11–2.92]* |
| Appropriate | 746 (82.1) | Reference | Reference | 716 (83.1) | Reference | Reference |
| Excessive | 345 (25.1) | 0.62 [0.41–0.79]* | 0.72 [0.59–1.05]* | 268 (20.3) | 0.61 [0.51–0.87]* | 0.69 [0.59–1.01]* |
| Estimated Gestational age (weeks) | ||||||
| EGA ≥34 – < 37 | 61 (51.2) | Reference | 58 (47.1) | Reference | ||
| EGA 37+ | 1168 (50.1) | 0.89 [0.50–1.31] | 1003 (48.9) | 0.91 [0.60–1.51] | ||
| Neonate weight | ||||||
| LGA | 182 (50.7) | 3.11 [1.81–5.25]* | 3.24 [1.93–6.33]* | 156 (48.1) | 3.28 [1.80–5.49]* | 3.55 [1.91–6.03]* |
| AGA | 982 (38.8) | Reference | Reference | 859 (39.6) | Reference | Reference |
| SGA | 65 (23.1) | 0.22 [0.18–0.41]* | 0.25 [0.18–0.40]* | 46 (19.3) | 0.29 [0.20–0.40]* | 0.28 [0.18–0.45]* |
Adjusted for: age category, smoking, hypertension, prenatal care, epidural, adherence to GWG, race, marital status, parity, diabetes, induction, augmentation, and estimated gestational age
*Significant Odds Ratios at the p < 0.05 level
GDM (Gestational Diabetes Mellitus), GWG (Gestational Weight Gain), IOM (Institute of Medicine), SGA (Small for Gestational Age), AGA (Appropriate of Gestational Age), LGA (Large for Gestational Age)