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Cited by 100Maternal and Perinatal Health InterventionsGestational Diabetes Research and ManagementObesity, Physical Activity, Diet

Maternal body mass index and duration of labor

Carlhäll, Sara, Källén, Karin, Blomberg, Marie·2013·European Journal of Obstetrics & Gynecology and Reproductive Biology
DOI 10.1016/j.ejogrb.2013.08.021
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Abstract

Objective To evaluate whether the duration of the active phase of labor is associated with maternal body mass index (BMI), in nulliparous women with spontaneous onset of labor.Study design Historical prospective cohort study including 63,829 nulliparous women with a singleton pregnancy and a spontaneous onset of labor, who delivered between January 1, 1995 and December 31, 2009. Data were collected from the Perinatal Revision South registry, a regional perinatal database in Southern Sweden. Women were categorized into six classes of BMI. Overweight and obese women were compared to normal weight women regarding duration of active labor. Adjustments were made for year of delivery, maternal age and infant birth weight.Results The median duration of labor was significantly longer in obese women (class I obesity (BMI 30-34.9) = 9.1h, class II obesity (BMI 35-39.9) = 9.2h and class III obesity (BMI > 40) = 9.8h) compared to normal-weight women (BMI 18.5-24.9) = 8.8h (p < 0.001). The risk of labor lasting more than 12h increased with increasing maternal BMI: OR 1.04 (1.01-1.06) (OR per 5-units BMI-increase).The risk of labor lasting more than 12h or emergency cesarean section within 12h, compared to vaginal deliveries within 12h, increased with increasing maternal BMI. Duration of the second stage of labor was significantly shorter in obese women: in class III obesity the median value was 0.45 h compared to normal weight women, 0.55 h (p < 0.001).Conclusion In nulliparous women with a spontaneous onset of labor, duration of the active phase of labor increased significantly with increasing maternal BMI. Once obese women reach the second stage they deliver more quickly than normal weight women, which implies that the risk of prolonged labor is restricted to the first stage of labor. It is clinically important to consider the prolonged first stage of labor in obese women, for example when diagnosing first stage labor arrest, in order to optimize management of this rapidly growing at-risk group of women. Thus, it might be reasonable to adapt the considered upper limit for duration of labor, according to maternal BMI.

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  • Obesity affects the length of gestation.

    “For instance, obesity affects the length of gestation [17], weekends tend to yield reduced childbirth frequency, and there are peaks in labor admission rates on Mondays and Fridays [3].”

    From Lunar Cycle Influences Spontaneous Delivery in Cows (2016) · cites this paper as [17]

  • Various factors could influence birth frequency in humans, which could mask the influence of the lunar phase.

    “However, various factors could influence birth frequency in humans, which could mask the influence of the lunar phase.”

    From Lunar Cycle Influences Spontaneous Delivery in Cows (2016) · cites this paper as [17]

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Authors
Carlhäll, S., Källén, K., & Blomberg, M.
Affiliations
  • Linköping University (SE)
  • Lund University (SE)
Corresponding author
Carlhäll, Sara
ORCID
Venue
European Journal of Obstetrics & Gynecology and Reproductive Biology
Publisher
Elsevier BV
Published
2013-11
Volume
171
Issue
1
Pages
49-53
ISSN
  • 0028-2243 (ISSN-L)
  • 0301-2115
DOI
10.1016/j.ejogrb.2013.08.021
OpenAlex
W2093153982
Cited by
100
References
28
Citations by year
2026: 4 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 8 · 2018: 10 · 2017: 13 · 2016: 7 · 2015: 9 · 2014: 3
FWCI
7.05
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
maternal body mass index, obesity, duration of labor, active phase of labor, prolonged labor, nulliparous women, spontaneous labor, second stage of labor, emergency cesarean section, labor arrest
MeSH terms
Adult, Birth Weight, Cesarean Section, Female, Humans, Infant, Newborn, Labor, Obstetric, Labor Stage, First, Obesity, Obesity, Morbid, Pregnancy, Pregnancy Complications, Prospective Studies, Sweden, Time Factors, Body Mass Index, Overweight

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