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Créée le : 18 Feb 2008
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Notice bibliographique (sans auteurs) :

The Association of Maternal Weight With Cesarean Risk, Labor Duration, and Cervical Dilation Rate During Labor Induction Obstet. Gynecol., Mar 2004; 103: 452 - 456.

Auteur·e(s) :

Francis S. Nuthalapaty, Dwight J. Rouse, John Owen

Année de publication :

2004

URL(s) :

http://www.greenjournal.org/cgi/content/abstract/1…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To assess the relationship among maternal weight and cesarean delivery, cervical dilation rate, and labor duration.

METHODS: We used a secondary analysis of 509 term women who were previously enrolled in a prospective observational study of a labor induction protocol in which standardized criteria were used for labor management. A variety of analyses were performed, both unadjusted and adjusted. P < .05 was considered significant.

RESULTS: The mean ± standard deviation weight of women who underwent a cesarean (97 ± 29 kg) was significantly higher than that of women who were delivered vaginally (87 ± 22 kg, P < .001). In a logistic regression model of nulliparas who comprised 71% of the study population, after adjustment for the confounding effects of infant birth weight, maternal age, initial cervical dilation, and diabetes, for each 10-kg increase in maternal weight, the odds ratio for cesarean delivery was significantly increased (odds ratio 1.17; 95% confidence interval 1.04, 1.28). In a linear regression model also limited to nulliparas and after adjusting for the same confounders, the rate of cervical dilation was inversely associated with maternal weight: for each 10-kg increment, the rate of dilation was decreased by 0.04 cm/h (P = .05). Similarly, labor duration was positively associated with maternal weight: for each 10-kg increment, an increase in the oxytocin to delivery interval of 0.3 hours was observed in nulliparas (P = .02). Neither lower rates of oxytocin administration to heavier women nor diminished uterine responsiveness (as reflected in measured Montevideo units) accounted for the slower labor progress.

CONCLUSION: In nulliparous women undergoing labor induction, maternal weight was associated with a higher cesarean risk and longer labor and was inversely proportional to the cervical dilation rate.

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Mots-clés :

➡ césarienne ; durée du travail ; poids maternel ; dilatation

Auteur·e de cette fiche :

Emmanuelle Phan — 18 Feb 2008
➡ dernière modification : Bernard Bel — 18 Feb 2008