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Am J Perinatol 2021; 38(04): 342-349
DOI: 10.1055/s-0039-1697586
Original Article

Obesity, Second Stage Duration, and Labor Outcomes in Nulliparous Women

Antonina I. Frolova 
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Nandini Raghuraman
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Molly J. Stout
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Methodius G. Tuuli
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
2   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
,
George A. Macones
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
,
Alison G. Cahill
1   Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations Funding A.G.C. is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061619, PI Cahill), which partially supported this work.
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Abstract

Objective This study aimed to estimate second stage duration and its effects on labor outcomes in obese versus nonobese nulliparous women.

Study Design This was a secondary analysis of a cohort of nulliparous women who presented for labor at term and reached complete cervical dilation. Adjusted relative risks (aRR) were used to estimate the association between obesity and second stage characteristics, composite neonatal morbidity, and composite maternal morbidity. Effect modification of prolonged second stage on the association between obesity and morbidity was assessed by including an interaction term in the regression model.

Results Compared with nonobese, obese women were more likely to have a prolonged second stage (aRR: 1.48, 95% CI: 1.18–1.85 for ≥3 hours; aRR: 1.65, 95% CI: 1.18–2.30 for ≥4 hours). Obesity was associated with a higher rate of second stage cesarean (aRR: 1.78, 95% CI: 1.34–2.34) and cesarean delivery for fetal distress (aRR: 2.67, 95% CI: 1.18–3.58). Obesity was also associated with increased rates of neonatal (aRR: 1.38, 95% CI: 1.05–1.80), but not maternal morbidity (aRR: 1.06, 95% CI: 0.90–1.25). Neonatal morbidity risk was not modified by prolonged second stage.

Conclusion Obesity is associated with increased risk of neonatal morbidity, which is not modified by prolonged second stage of labor.

Keywords

labor - obesity - second stage - second stage cesarean - second stage duration


Publication History

Received: 31 March 2019

Accepted: 12 August 2019

Article published online:
28 September 2019

© 2019. Thieme. All rights reserved.

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