Characterize the relation between obese body mass index (BMI) groups and labor interventions and outcomes.
Data were abstracted from medical records for a cohort of obese women at a single Colorado hospital from 2005-2012. Women were nulliparous, at term, and aged 18-40 years. Women were grouped into WHO Obesity Groups: I (30≤BMI<35), II (35≤BMI<40), and III (BMI≥ 40). Exclusion criteria included history of diabetes, hypertension, planned cesarean delivery, and diagnosis of fetal anomaly. Logistic regression and survival analysis were used to evaluate associations between obesity class and labor outcomes.
Women in Obesity BMI III had the shortest median time-to-delivery (314 minutes) among women unexposed to oxytocin and the longest median time-to-delivery among women exposed to oxytocin (864 minutes). The odds of inappropriate oxytocin initiation relative to six centimeters dilation increased with increasing obesity BMI group. The odds of inappropriate oxytocin intervention based on partograph time were higher for women in Obesity BMI II and III than I.
Obese women were at increased odds of inappropriately timed oxytocin as their obesity group increased at a Colorado Hospital. Identifying factors that affect clinical decisions to administer oxytocin and how they differ by obesity class could provide insight into these results.
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About this Master's Thesis
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|File download under embargo until 17 August 2019||2018-08-08||File download under embargo until 17 August 2019|