Abstract
Introduction: Obesity (body mass index [BMI] ≥ 30 kg/m²) is increasingly prevalent in pregnancy and is associated with numerous complications, including gestational diabetes, hypertension, and higher cesarean delivery (CD) rate. There are many risks for patients with obesity during pregnancy; however, there is little evidence supporting early-term (37 0/7 to 38 6/7 weeks of gestation) induction of labor (IOL) to reduce complications. This study aimed to evaluate whether IOL in patients with obesity is associated with a decreased CD rate.
Methods: This retrospective cohort study included pregnancies that underwent IOL between 37 0/7 and 41 6/7 weeks of gestation from 2018-2023 at a single institution. Exclusion criteria included pre-labor rupture of membranes, spontaneous labor, prior CD, multiple gestations, fetal anomalies, or non-vertex presentation. The primary exposures were pre-gravid BMI (≥ 30 vs. < 30 kg/m²) and gestational age (GA) at IOL (≥ 39 vs. < 39 weeks of gestation). The primary outcome was CD rate; secondary outcomes included shoulder dystocia (SD), obstetric anal sphincter injuries (OASIS), postpartum hemorrhage (PPH), and neonatal intensive care unit (NICU) admission.
Results: Of the 6,477 patients included, 69.7% had obesity, and 70.7% delivered at ≥ 39 weeks. Obesity was associated with higher rates of CD (20.6% vs. 12.1%, p
Discussion: In patients with obesity, early term IOL does not reduce cesarean delivery rates. It may, however, decrease the risk of SD, although this benefit may be accompanied by an increased risk of NICU admission. Further prospective studies are required to establish the optimal timing of delivery in this population.
Recommended Citation
Hoskins NN, Patel P, Wasser T, Jiang X. Impact of Early Term Induction of Labor on Cesarean Delivery and Maternal-Fetal Outcomes in Patients with Obesity: A Retrospective Cohort Study. Transformative Medicine. 2025; 4(4):54-57. doi: https://doi.org/10.54299/tmed/fojv4601.