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Attempted and Successful Vacuum-Assisted Vaginal Delivery by Prepregnancy Body Mass Index.
Obstet Gynecol 2017; 129(2):311-320OG

Abstract

OBJECTIVE

To examine rates of attempted and successful vacuum-assisted vaginal delivery by prepregnancy body mass index (BMI).

METHODS

We conducted a retrospective cohort study of 2,084 women with singleton gestations needing operative delivery assistance and vacuum-eligible (fully dilated, +2 station or greater, 34 weeks of gestation or greater) using 2006-2014 inpatient records. Prepregnancy BMI was categorized as underweight (less than 18.5), normal weight (18.5 to less than 25), overweight (25 to less than 30), or obese (30 or greater). Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of attempted and successful vacuum-assisted vaginal delivery by prepregnancy BMI adjusted for age, race, marital status, parity, diabetes, labor induction-augmentation, episiotomy, gestational age, and neonatal birth weight.

RESULTS

Thirty-nine percent of women requiring delivery assistance and eligible for a vacuum were overweight or obese, 79% had vacuum attempts, and 95.3% of attempted vacuum-assisted vaginal deliveries were successful. Compared with women who were normal weight prepregnancy (82.8%), women who were overweight or obese were less likely to have vacuum attempted (75.8%, OR 0.71, 95% CI 0.53-0.96 and 71.2%, OR 0.53, 95% CI 0.39-0.74, respectively). Among women with attempted vacuum-assisted vaginal delivery, successful delivery did not differ by prepregnancy BMI (92.6%, OR 0.54, 95% CI 0.21-1.37 for underweight; 94.5%, OR 1.07, 95% CI 0.57-2.00 for overweight; 96.3%, OR 1.09, 95% CI 0.51-2.33 for obese compared with 95.6% among normal-weight women).

CONCLUSION

Among women in need of operative delivery assistance, prepregnancy obesity was associated with lower likelihood of attempted vacuum-assisted vaginal delivery but, if attempted, success rates were similar to rates among normal-weight women. With significant morbidity of second-stage cesarean delivery in obese women, research should examine whether vacuum-assisted vaginal delivery may be appropriate for additional obese patients.

Authors+Show Affiliations

Division of Research, Department of Obstetrics and Gynecology, the Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, and the Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28079766

Citation

Ramos, Sebastian Z., et al. "Attempted and Successful Vacuum-Assisted Vaginal Delivery By Prepregnancy Body Mass Index." Obstetrics and Gynecology, vol. 129, no. 2, 2017, pp. 311-320.
Ramos SZ, Waring ME, Leung K, et al. Attempted and Successful Vacuum-Assisted Vaginal Delivery by Prepregnancy Body Mass Index. Obstet Gynecol. 2017;129(2):311-320.
Ramos, S. Z., Waring, M. E., Leung, K., Amir, N. S., Bannon, A. L., & Moore Simas, T. A. (2017). Attempted and Successful Vacuum-Assisted Vaginal Delivery by Prepregnancy Body Mass Index. Obstetrics and Gynecology, 129(2), pp. 311-320. doi:10.1097/AOG.0000000000001847.
Ramos SZ, et al. Attempted and Successful Vacuum-Assisted Vaginal Delivery By Prepregnancy Body Mass Index. Obstet Gynecol. 2017;129(2):311-320. PubMed PMID: 28079766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attempted and Successful Vacuum-Assisted Vaginal Delivery by Prepregnancy Body Mass Index. AU - Ramos,Sebastian Z, AU - Waring,Molly E, AU - Leung,Katherine, AU - Amir,Nili S, AU - Bannon,Annika L, AU - Moore Simas,Tiffany A, PY - 2017/1/13/pubmed PY - 2017/7/14/medline PY - 2017/1/13/entrez SP - 311 EP - 320 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 129 IS - 2 N2 - OBJECTIVE: To examine rates of attempted and successful vacuum-assisted vaginal delivery by prepregnancy body mass index (BMI). METHODS: We conducted a retrospective cohort study of 2,084 women with singleton gestations needing operative delivery assistance and vacuum-eligible (fully dilated, +2 station or greater, 34 weeks of gestation or greater) using 2006-2014 inpatient records. Prepregnancy BMI was categorized as underweight (less than 18.5), normal weight (18.5 to less than 25), overweight (25 to less than 30), or obese (30 or greater). Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of attempted and successful vacuum-assisted vaginal delivery by prepregnancy BMI adjusted for age, race, marital status, parity, diabetes, labor induction-augmentation, episiotomy, gestational age, and neonatal birth weight. RESULTS: Thirty-nine percent of women requiring delivery assistance and eligible for a vacuum were overweight or obese, 79% had vacuum attempts, and 95.3% of attempted vacuum-assisted vaginal deliveries were successful. Compared with women who were normal weight prepregnancy (82.8%), women who were overweight or obese were less likely to have vacuum attempted (75.8%, OR 0.71, 95% CI 0.53-0.96 and 71.2%, OR 0.53, 95% CI 0.39-0.74, respectively). Among women with attempted vacuum-assisted vaginal delivery, successful delivery did not differ by prepregnancy BMI (92.6%, OR 0.54, 95% CI 0.21-1.37 for underweight; 94.5%, OR 1.07, 95% CI 0.57-2.00 for overweight; 96.3%, OR 1.09, 95% CI 0.51-2.33 for obese compared with 95.6% among normal-weight women). CONCLUSION: Among women in need of operative delivery assistance, prepregnancy obesity was associated with lower likelihood of attempted vacuum-assisted vaginal delivery but, if attempted, success rates were similar to rates among normal-weight women. With significant morbidity of second-stage cesarean delivery in obese women, research should examine whether vacuum-assisted vaginal delivery may be appropriate for additional obese patients. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/28079766/Attempted_and_Successful_Vacuum_Assisted_Vaginal_Delivery_by_Prepregnancy_Body_Mass_Index_ L2 - http://Insights.ovid.com/pubmed?pmid=28079766 DB - PRIME DP - Unbound Medicine ER -