Examining the Effect of Maternal Obesity on Outcome of Labor Induction in Patients with Preeclampsia

Abstract

Objective The objective of this investigation was to evaluate the effect of maternal obesity, as measured by prepregnancy body mass index (BMI), on the mode of delivery in women undergoing indicated induction of labor for preeclampsia. Study Design Following Institutional Review Board (IRB) approval, patients with preeclampsia who underwent an induction of labor from 1997 to 2007 were identified from a perinatal information database, which included historical and clinical information. Data analysis included bivariable and multivariable analyses of predictor variables by mode of delivery. An artificial neural network was trained and externally validated to independently examine predictors of mode of delivery among women with preeclampsia. Results Six hundred and eight women met eligibility criteria and were included in this investigation. Based on multivariable logistic regression (MLR) modeling, a 5-unit increase in BMI yields a 16% increase in the odds of cesarean delivery. An artificial neural network trained and externally validated confirmed the importance of obesity in the prediction of mode of delivery among women undergoing labor induction for preeclampsia. Conclusion Among patients who are affected by preeclampsia, obesity complicates labor induction. The risk of cesarean delivery is enhanced by obesity, even with small increases in BMI. Prediction of mode of delivery by an artificial neural network performs similar to MLR among patients undergoing labor induction for preeclampsia.

• Body mass index
• Cesarean delivery
• Obesity
• Severe preeclampsia

ACKNOWLEDGMENTS

This work was supported by Clinical and Translational Science K12 Award, National Institutes of Health/National Library of Medicine, grant number 5 T15 LM007438-04.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.