Elevated maternal lipids in early pregnancy are not associated with risk of intrapartum caesarean in overweight and obese nulliparous women

BMC Pregnancy and Childbirth

Lesley ME McCowan⁴  Gustaaf A Dekker³  Katie M Groom⁴  Kamala PL Thiyagarajan³  John MD Thompson¹  Karen S Rivers³  Elaine M Fyfe² 

[1] Department of Paediatrics, University of Auckland, Private Bag 92019, Auckland, New Zealand;Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, Private Bag 92019, Auckland, New Zealand;Women and Children’s Division, Lyell McEwin Hospital, University of Adelaide, Adelaide, Australia;Department of Obstetrics and Gynaecology, University of Auckland, Private Bag 92019, Auckland, New Zealand

关键词: Labour;    Obesity;    Delivery;    Antenatal;    Cholesterol;   

Others  :  1137957
DOI  :  10.1186/1471-2393-13-143

 received in 2012-11-25, accepted in 2013-07-01,  发布年份 2013

【 摘 要 】

Background

Maternal overweight and obesity are associated with slower labour progress and increased caesarean delivery for failure to progress. Obesity is also associated with hyperlipidaemia and cholesterol inhibits myometrial contractility in vitro. Our aim was, among overweight and obese nulliparous women, to investigate 1. the role of early pregnancy serum cholesterol and 2. clinical risk factors associated with first stage caesarean for failure to progress at term.

Methods

Secondary data analysis from a prospective cohort of overweight/obese New Zealand and Australian nullipara recruited to the SCOPE study. Women who laboured at term and delivered vaginally (n=840) or required first stage caesarean for failure to progress (n=196) were included. Maternal characteristics and serum cholesterol at 14–16 weeks’ of gestation were compared according to delivery mode in univariable and multivariable analyses (adjusted for BMI, maternal age and height, obstetric care type, induction of labour and gestation at delivery ≥41 weeks).

Results

Total cholesterol at 14–16 weeks was not higher among women requiring first stage caesarean for failure to progress compared to those with vaginal delivery (5.55 ± 0.92 versus 5.67 ± 0.85 mmol/L, p= 0.10 respectively). Antenatal risk factors for first stage caesarean for failure to progress in overweight and obese women were BMI (adjusted odds ratio [aOR (95% CI)] 1.15 (1.07-1.22) per 5 unit increase, maternal age 1.37 (1.17-1.61) per 5 year increase, height 1.09 (1.06-1.12) per 1cm reduction), induction of labour 1.94 (1.38-2.73) and prolonged pregnancy ≥41 weeks 1.64 (1.14-2.35).

Conclusions

Elevated maternal cholesterol in early pregnancy is not a risk factor for first stage caesarean for failure to progress in overweight/obese women. Other clinically relevant risk factors identified are: increasing maternal BMI, increasing maternal age, induction of labour and prolonged pregnancy ≥41 weeks’ of gestation.

【 授权许可】

   
2013 Fyfe et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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