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Labor

Poster Session 4

(957) The Impact of Gestational Weight Gain on Total Labor Length among Patients with Obesity

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Excessive gestational weight gain (GWG) and pre-pregnancy obesity are associated with decreased rates of spontaneous labor and increased cesarean birth. Current Institute of Medicine (IOM) guidelines establish a single recommendation for GWG in patients with obesity of all classes. We sought to assess the impact of increasing GWG on labor length and time from rupture of membranes (ROM) to vaginal delivery in patients with pre-pregnancy obesity undergoing induction of labor.

Study Design: This retrospective cohort study included nulliparous, term, singleton, vertex presentation patients that underwent induction of labor at our institution between January 2020-May 2021 and had a vaginal delivery. Patients with pre-pregnancy BMI < 30 and who delivered via cesarean were excluded. GWG was calculated based on difference between pre-pregnancy weight and weight at delivery admission. Outcomes included total labor length (i.e., time of initial induction agent to delivery time) and ROM time (i.e., time of ROM to delivery). Univariable and multivariable linear regression models tested for the impact of severity of maternal obesity, gestational weight gain, and maternal age on mean differences in total labor length and ROM time. 

Results: Pre-pregnancy class of obesity was not a significant predictor of total labor length or ROM time. Conversely, increasing GWG was associated with increased total labor length in both adjusted and unadjusted models (Table 1). Increasing maternal age was also associated with increased labor length time in both models. GWG was not a significant predictor of ROM time when adjusting for other variables in the model. Models controlled for gestational age at delivery and neonatal birth weight. 

Conclusion: Our data indicate that increasing GWG is a risk factor for longer labor inductions in the obese population. Class of obesity did not impact labor outcomes, reinforcing current IOM guidelines for patients with BMI > 30. These data also inform patient counseling on impact of GWG on labor timing. Future work should aim to create standardized induction protocols for patients with obesity.