Maeder AB, Vonderheid SC, Park CG, Bell AF, McFarlin BL, Vincent C, Carter CS. Titration of Intravenous Oxytocin Infusion for Postdates Induction of Labor Across Body Mass Index Groups.
J Obstet Gynecol Neonatal Nurs 2017;
46:494-507. [PMID:
28528810 DOI:
10.1016/j.jogn.2017.02.006]
[Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2017] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE
To evaluate whether oxytocin titration for postdates labor induction differs among women who are normal weight, overweight, and obese and whether length of labor and birth method differ by oxytocin titration and body mass index (BMI).
DESIGN
Retrospective cohort study.
SETTING
U.S. university-affiliated hospital.
PARTICIPANTS
Of 280 eligible women, 21 were normal weight, 134 were overweight, and 125 were obese at labor admission.
METHODS
Data on women who received oxytocin for postdates induction between January 1, 2013 and June 30, 2013 were extracted from medical records. Oxytocin administration and labor outcomes were compared across BMI groups, controlling for potential confounders. Data were analyzed using χ2, analysis of variance, analysis of covariance, and multiple linear and logistic regression models.
RESULTS
Women who were obese received more oxytocin than women who were overweight in the unadjusted analysis of variance (7.50 units compared with 5.92 units, p = .031). Women who were overweight had more minutes between rate changes from initiation to maximum than women who were obese (98.19 minutes compared with 83.39 minutes, p = .038). Length of labor increased with BMI (p = .018), with a mean length of labor for the normal weight group of 13.96 hours (standard deviation = 8.10); for the overweight group, 16.00 hours (standard deviation = 7.54); and for the obese group, 18.30 hours (standard deviation = 8.65). Cesarean rate increased with BMI (p = .001), with 4.8% of normal weight, 33.6% of overweight, and 42.4% of obese women having cesarean births.
CONCLUSION
Women who were obese and experienced postdates labor induction received more oxytocin than women who were non-obese and had longer length of labor and greater cesarean rates.
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