Table 3.
Maternal and neonatal outcomes of nulliparous obese women undergoing elective induction of labor compared to expectant management
| eIOL | EM | eIOL | EM | eIOL | EM | |
|---|---|---|---|---|---|---|
| Pregnancy outcomes: | 390/7 -393/7 | >393/7 | 400/7 -403/7 | >403/7 | 410/7 -413/7 | >413/7 |
| Nulliparous women | (n=573) | (n=3,139) | (n=1,343) | (n=1,334) | (n=695) | (n=160) |
| Maternal outcomes | ||||||
| Cesarean delivery | 224 (39.1) | 1,329 (41.6) | 532 (39.6)* | 603 (45.2) | 330 (47.5) | 70 (43.8) |
| Operative vaginal delivery | 39 (6.8) | 256 (8.0) | 117 (8.7) | 96 (7.2) | 49 (7.1) | 9 (5.6) |
| 3rd/4th degree laceration | 16 (2.8) | 89 (2.8) | 51 (3.8)* | 22 (1.7) | 13 (1.9) | 4 (2.5) |
| Postpartum Hemorrhage | 18/416 (4.3) | 101/2,379 (4.3) | 40/944 (4.2) | 51/1,063 (4.8) | 21/530 (4.0) | 7/141 (5.0) |
| Endometritis† | 5/228 (2.2) | 25/1,351 (1.9) | 7/528 (1.3) | 13/597 (2.2) | 7/312 (2.2) | 2/69 (2.9) |
| Wound complications (infection/separation)† | 4/332 (1.2) | 32/1,848 (1.7) | 6/848 (0.7) | 18/3,629 (0.5) | 9/1,043 (0.9) | 0/218 (0.0) |
| Blood transfusion† | 14/369 (3.8) | 76/1,807 (4.2) | 32/739 (4.3) | 28/692 (4.1) | 12/323 (3.7) | 2/62 (3.2) |
| Hysterectomy | 0 (0.0) | 2 (0.1) | 1 (0.1) | 1 (0.1) | 0 (0.0) | 1 (0.6) |
| Pulmonary embolism | 0 (0.0) | 3 (0.1) | 1 (0.1) | 1 (0.1) | 1 (0.2) | 0 (0.0) |
| ICU admission† | 0/508 (0.0) | 4/2,578 (0.2) | 2 (0.2) | 2 (0.2) | 1 (0.2) | 0 (0.0) |
| Maternal death | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Neonatal outcomes | ||||||
| Birth weight | 3,385 ± 436* | 3,535 ± 448 | 3,514 ± 436* | 3,602 ± 449 | 3,616 ± 449 | 3,662 ± 478 |
| Shoulder dystocia | 11 (2.0) | 52 (1.8) | 17 (1.3) | 22 (1.9) | 8 (1.3) | 2 (1.7) |
| SGA | 64 (11.2) | 341 (10.7) | 150 (11.2) | 133 (10.0) | 75 (10.8) | 15 (9.4) |
| LGA | 59 (10.3) | 370 (11.6) | 143 (10.7) | 170 (12.8) | 83 (12.0) | 24 (15.0) |
| Macrosomia | 46 (8.0)* | 456 (14.3) | 162 (12.1)* | 247 (18.5) | 138 (19.9) | 36 (22.5) |
| Apgar<7 at 5 min | 3 (0.5) | 45 (1.4) | 13 (1.0) | 23 (1.7) | 10 (1.4) | 2 (1.3) |
| NICU admission | 43 (7.5) | 318 (10.0) | 115 (8.6)* | 148 (11.1) | 73 (10.5) | 20 (12.5) |
| HIE | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Antepartum/intrapartum death | 2 (0.4) | 7 (0.2) | 5 (0.4) | 2 (0.2) | 0 (0.0) | 0 (0.0) |
| Neonatal death | 0 (0.0) | 1 (0.03) | 0 (0.0) | 1.(0.1) | 1 (0.3) | 0 (0.0) |
All data presented as mean standard deviation or N (%)
*
= p<0.05 for comparison of elective labor induction versus expectant management at the given gestational age
†
= The denominator excludes deliveries with missing data for this variable
eIOL, elective induction of labor; EM, expectant management; BMI, body mass index
SGA, small-for-gestational-age, LGA, large-for-gestational-age, NICU, neonatal intensive care unit, HIE, hypoxic ischemic encephalopathy, ICU, intensive care unit.