Body Mass Index and the odds of reaching the active phase of induced
labour: A cohort study
Abstract
Objective To investigate the association between Body Mass
Index (BMI) and the odds of reaching the active phase of induced labour.
Design Cohort study. Setting Delivery sites in the
Central Denmark Region from 2013 to 2022. Population Pregnant
women with a singleton foetus in cephalic presentation induced at 37
weeks of gestation or beyond. We excluded women with spontaneous
pre-labour rupture of membranes, uterine scar or intrauterine foetal
demise. Methods Information was retrieved from the electronic
patient record. We used logistic regression analyses adjusting for
potential confounders and modelled BMI as categorical and continuous
variable using restricted cubic spline analysis. Exposure was defined
according to the World Health Organization BMI groups. Main
Outcome Measure Reaching active phase of labour. Results Of
the 22,114 women in the cohort, the proportion reaching the active phase
of labour was 98%, 97%, 96%, 95% and 95%, for each BMI group.
Compared to normal weight, the adjusted odds ratios (aOR) and 95%
confidence intervals (CI) were aOR 0.6 (95% CI 0.5, 0.8) for
overweight, aOR 0.5 (95% CI 0.3, 0.7) for obesity class I, aOR 0.4
(95% CI 0.3, 0.5) for obesity class II and aOR 0.4 (95% CI 0.2, 0.7)
for obesity class III. A similar pattern was found when using restricted
cubic splines. Conclusion In singleton pregnant women induced
at term, higher BMI was associated with lower odds of reaching the
active phase of labour. Regardless of BMI, 95% to 98% of all women in
the cohort reached the active phase of labour, and 80% to 90% gave
birth vaginally.