Can recurrent cesarean section due to arrest of descent be predicted by newborn weight difference?

Aims: To assess the influence of obesity on pregnancy and delivery in pregnant nulliparous women. Methods: A cohort, longitudinal, retrospective study was conducted in Spain with 710 women, of which 109 were obese (BMI > 30) and 601 were normoweight (BMI < 25). Consecutive nonrandom sampling. Variables: maternal age, BMI, gestational age, fetal position, start of labor, dilation and expulsion times, type of delivery and newborn weight and height. Results: The dilation time in obese women (309.81 ± 150.42 min) was longer than that in normoweight women (281.18 ± 136.90 min) (p = 0.05, Student’s t-test). A higher fetal weight was more likely to lead to longer dilation time (OR = 0.43, 95% CI 0.010–0.075, p < 0.001) and expulsion time (OR = 0.027, 95% CI 0.015–0.039, p < 0.001). A higher maternal age was more likely to lead to a longer expulsion time (OR = 2.054, 95% CI 1.17–2.99, p < 0.001). Obese women were more likely to have gestational diabetes [relative risk (RR) = 3.612, 95% CI 2.102–6.207, p < 0.001], preeclampsia (RR = 5.514, 95% CI 1.128–26.96, p = 0.05), induced birth (RR = 1.26, 95% CI 1.06–1.50, p = 0.017) and cesarean section (RR = 2.16, 95% CI 1.11–4.20, p = 0.022) than normoweight women. Conclusion: Obesity is associated with increased complications during pregnancy, an increased incidence of a cesarean section and induced birth but it has no significant effect on the delivery time.

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The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section

Biological Research For Nursing ◽

10.1177/1099800417706023 ◽

2017 ◽

Vol 19 (4) ◽

pp. 393-398 ◽

Cited By ~ 2

Author(s):

Antonio Herrera-Gómez ◽

Elvira De Luna-Bertos ◽

Javier Ramos-Torrecillas ◽

Francisco Manuel Ocaña-Peinado ◽

Olga García-Martínez ◽

...

Keyword(s):

Cesarean Section ◽

Epidural Analgesia ◽

Cesarean Delivery ◽

Maternal Age ◽

Well Being ◽

Labor Pain ◽

Cesarean Deliveries ◽

Increased Risk ◽

Newborn Weight ◽

Fetal Position

Introduction: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. Method: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 ( N = 2,450; EA = 562, non-EA = 1,888). Results: Risk of a cesarean section was significantly increased by EA administration (odds ratio [ OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. Conclusion: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

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