Am J Perinatol 2020; 37(04): 349-356
DOI: 10.1055/s-0039-1694982
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Maternal Obesity on Oxytocin Requirements to Achieve Vaginal Delivery

1  Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Women's and Infant Services, Washington, District of Columbia
,
Elizabeth M. Coviello
1  Division of Maternal-Fetal Medicine, MedStar Washington Hospital Center, Women's and Infant Services, Washington, District of Columbia
,
Daphnie Drassinower
2  Division of Maternal-Fetal Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia
› Author Affiliations
Funding None.
Further Information

Publication History

28 January 2019

09 July 2019

Publication Date:
20 August 2019 (online)

Abstract

Objective Our objective was to determine if obese women are more likely to require oxytocin rates > 20 mU/min to achieve vaginal delivery, compared with normal weight women.

Study Design This is a retrospective cohort study of deliveries at the MedStar Washington Hospital Center and MedStar Georgetown University Hospital.

Results There were 4,284 births included in the analysis. Thirty-three per cent of deliveries were among women classified as overweight (body mass index [BMI] 25–29.9 kg/m2) and 58% were among women classified as obese (BMI >30.0 kg/m2), 12% were classified as class III obesity (BMI >40 kg/m2). Overall 110 (2.6%) women required an oxytocin rate of >20 mU/min. Doses of oxytocin >20 mU/min for women in the overweight, class I obesity, and class II obesity groups were 2.6, 1.9, and 1.6%, respectively. Deliveries among women with class III obesity had a significantly longer duration of oxytocin exposure (10.7 hours) compared with the normal weight group (8.2 hours, p < 0.001), and had a higher maximum rate of oxytocin compared (10 mU/min) to normal weight women (8 mU/min, p < 0.001).

Conclusion Obese women are more likely to require oxytocin rates more than 20 mU/min, higher doses of oxytocin, and greater duration of oxytocin exposure to achieve a vaginal delivery.

Note

The findings of this study were presented at the 38th Annual Pregnancy Meeting of the Society of Maternal-Fetal Medicine, January 29–February 3, 2018, Dallas, TX.