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Effect of obesity on the length of the first and second stages of labor

Objective This study was designed to evaluate the length of the first and second stages of labor in nulliparous obese Egyptian women and compare them with those in women with normal BMI. Background Maternal obesity is now the most common risk factor for maternal mortality in developed countries and is also associated with a wide spectrum of adverse pregnancy outcomes. The duration of first stage of labor, the rate of cesarean delivery, and inadequate progress of cervical dilatation during labor were found to be higher in women with BMI more than 30 compared with women of average weight. Participants and methods Nulliparous women of more than 37 gestational weeks who were in labor were included in this study. First-visit BMI was used to categorize weight as normal (≤24) or obese (≥30). Over 12 months (study period), we observed 603 deliveries; 239 were nulliparous and 211 were term singleton. Eighty women met the inclusion criteria: 40 women with normal BMI constituting the control group and 40 obese women who constituted the study group. Results The duration of first stage of labor was significantly longer in obese women compared with normal weight women (19.76 ± 0.77 vs. 16.87 ± 0.66 h; P < 0.001), whereas the duration of the second stage of labor showed no significant difference between obese and normal weight women (61.0 ± 34.8 vs. 60.9 ± 34.3 min; P = 0.990). When adjusted for age, hypertension, and induction, the likelihood of completing stages I and II was significantly lower among obese nulliparous than among those with BMI 24 or less. Conclusion About half of nulliparous women in our population are obese and the duration of stage I is significantly longer among them, whereas the second stage of labor may be independent of maternal BMI. The second stage in the nulliparous parturient woman does not appear to be longer or more likely to end in cesarean delivery on the basis of prepregnancy BMI