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- W2998255062 abstract "Overweight and obese women follow slower labor curves and have higher rates of cesarean section than normal weight women. In vitro data suggest this may be due to changes in myometrial response to oxytocin. The purpose of this study is to observe differences in oxytocin dosing administered to women with varying body mass index (BMI) undergoing induction of labor who achieved vaginal birth. This was a retrospective cohort study of women who received oxytocin for induction of labor at term and achieved vaginal birth in 2016 at a single institution. Women with singleton gestations, ages 18–45, presenting for induction of labor were included. Exclusion criteria were women presenting in labor or with ruptured membranes, fetal demise, prior cesarean, or contraindication to vaginal birth. Comparison groups were based on BMI< 24.99 or BMI >25. Our primary outcome was total cumulative oxytocin dose administered. Data were analyzed using univariate and multivariate analyses. 620 women were identified and included in the final analysis. Women with BMI >25 received more oxytocin than women with BMI < 24.99 (p 0.021). Compared to BMI < 24.99, women with BMI 25-29.99, 30-34.99, 35-39.99, and >40 received 1.67, 1.73, 1.80, and 1.88 times more oxytocin respectively. This demonstrates a linear relationship between BMI and total oxytocin dose. Additional factors associated with higher doses of oxytocin were elective induction of labor (p 0.065), nulliparity (p 0.057), lack of ripening with misoprostol (p< 0.001), diabetes (p 0.078), hypertension (p 0.003), magnesium (p 0.001), and intrauterine pressure catheter (p 0.001). Multivariate analysis of confounders revealed a persistent association between BMI and oxytocin dose (p 0.004). Overweight and obese women who achieve vaginal delivery following induction of labor require significantly more oxytocin than normal weight women. Further investigation is needed to determine protocols for appropriate maternal oxytocin dosing in the obese population." @default.
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- W2998255062 date "2020-01-01" @default.
- W2998255062 modified "2023-10-15" @default.
- W2998255062 title "1189: Effect of body mass index on oxytocin required to achieve vaginal birth" @default.
- W2998255062 doi "https://doi.org/10.1016/j.ajog.2019.11.1201" @default.
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