caa a22 4500 445308257 CHVBK 20180317142620.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00404-010-1502-5 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1502-5 Obesity decreases the chance to deliver spontaneously [Elektronische Daten] [Daniel Beyer, Feriel Amari, Dörte Lüdders, Klaus Diedrich, Jan Weichert] Purpose: To evaluate the impact of maternal obesity on labour, intrapartual assessment and delivery. Methods: Retrospective cohort analysis of n=11,681 deliveries supervised between 01 January 2000 and 31 December 2009. Results were analysed dividing the patients into two main groups according to their body mass index (BMI): group 1, control: BMI 18-24.9 and group 2 BMI, test>25. Subgroups were built: (0) BMI 25-29.9, (I) BMI 30-34.9, (II) BMI 35-39.9, (III) BMI>40. Exclusion criteria were defined as: delivery <37+0weeks p.m., multiple pregnancy, comorbidity other than GDM, abnormal presentation, BMI <18.5, and incomplete data. The main outcome parameter was defined as secondary caesarean delivery rate and mode of delivery. Results: N=8,379 patients met the inclusion criteria and were divided in two groups: 1, n=4,464 patients and 2, n=3,915. Basic maternal characteristics including foetal vital parameters were equal in all groups. GDM occurred more frequently in obese patients (P<0.001). For the main outcome parameter a significant decrease in the rate of spontaneous delivery between control/test groups (72-66%, P<0.001) and control/I-III groups (72 vs. 50%, P<0.001) could be observed. The rate of secondary c-section increased significantly according to a higher BMI (>40: OR 2.5, 95% CI 1.84-3.61, χ2P<0.001). The groups showed no difference in the rate of injuries during delivery though foetal birth weight increased significantly with a higher BMI (3,412-3,681g; P<0.001). Conclusion: Obesity decreases the chance to deliver spontaneously. Moreover, the obese patient suffers from a significantly longer trial of labour (7.9 vs. 9.5h) and an elevated risk of surgical delivery. Springer-Verlag, 2010 Obesity nationallicence Labour nationallicence Mode of delivery nationallicence Maternal injury nationallicence Foetal outcome nationallicence BMI : Body mass index nationallicence CI : Confidence interval nationallicence RRR : Relative risk reduction nationallicence OR : Odds ratio nationallicence GDM : Gestational diabetes mellitus nationallicence Beyer Daniel Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut Amari Feriel Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut Lüdders Dörte Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut Diedrich Klaus Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut Weichert Jan Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 981-988 0932-0067 283:5<981 2011 283 404 https://doi.org/10.1007/s00404-010-1502-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1502-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Beyer Daniel Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut NATIONALLICENCE 700 1- Amari Feriel Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut NATIONALLICENCE 700 1- Lüdders Dörte Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut NATIONALLICENCE 700 1- Diedrich Klaus Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut NATIONALLICENCE 700 1- Weichert Jan Division of Perinatal Medicine, Department of Obstetrics and Gynaecology, Schleswig-Holstein University, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 981-988 0932-0067 283:5<981 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer