Abstract
Objective
This study sought to evaluate the use of the Edmonton Obesity Staging System (EOSS)
in predicting cesarean delivery among term, nulliparous, singleton pregnancies in
women with overweight or obesity who are undergoing an induction of labour.
Methods
A prospective cohort study was performed in Edmonton, Alberta. Women undergoing an
induction of labour at term were recruited to either a sample cohort, including women
with a body mass index of ≥25 kg/m2 at first antenatal visit, or a control cohort with a body mass index of 18.5 to 24.9
kg/m2. Participating women provided a self-reported health history and consented to review
of their medical records allowing allocation into EOSS categories. The primary outcome
was the rate of cesarean delivery based on EOSS category. Secondary outcomes consisted
of a summary score of adverse maternal, delivery, and neonatal events (Canadian Task
Force Classification II-2).
Results
Overall, 345 women were recruited, with a participation rate of 93.7%. The sample
cohort consisted of 276 women with overweight or obesity, whereas the control cohort
included 69 normal-weight women. The overall rate of cesarean delivery was 30.4% for
the control cohort and 35.8%, 29.9%, 43.2%, and 90.5% for women assigned an EOSS category
0, 1, 2, and 3, respectively (P < 0.001). A summary score was not indicative of overall rate of adverse maternal,
delivery, and neonatal events (P = 0.22).
Conclusion
The EOSS may help predict the chance of cesarean delivery in a high-risk group of
nulliparous women with overweight or obesity who are undergoing an induction of labour
at term.
Résumé
Objectif
Cette étude visait à évaluer l'utilisation du système de classification de l'obésité
EOSS (Edmonton Obesity Staging System) pour prédire la probabilité d'un accouchement
par césarienne en cas de déclenchement artificiel du travail d'une grossesse monofœtale
à terme chez une femme nullipare en surpoids ou atteinte d'obésité.
Méthodologie
Une étude de cohorte prospective a été réalisée à Edmonton en Alberta. Les chercheurs
ont recruté des femmes devant subir un déclenchement artificiel du travail d'une grossesse
à terme et les ont réparties en deux groupes : soit dans un groupe-échantillon de
femmes ayant un indice de masse corporelle de 25 kg/m2 ou plus lors de la première consultation de suivi prénatal, soit dans un groupe témoin
de femmes ayant un indice de masse corporelle de 18,5 à 24,9 kg/m2. Les participantes ont autodéclaré leurs antécédents médicaux et consenti à l'examen
de leur dossier médical aux fins de classification en fonction des catégories de l'EOSS.
Le taux de césariennes fondé sur la classification de l'EOSS constituait le critère
de jugement principal. Les critères de jugement secondaires consistaient en un indice
global des événements défavorables maternels, obstétricaux et néonataux (classification
II-2 du Groupe d'étude canadien sur les soins de santé préventifs).
Résultats
Un total de 345 femmes ont été recrutées pour cette étude, laquelle présente un taux
de participation de 93,7 %. Le groupe-échantillon se compose de 276 femmes en surpoids
ou atteintes d'obésité, tandis que le groupe témoin comprend 69 femmes de poids normal.
Le taux de césariennes global est de 30,4 % pour les femmes du groupe témoin et de
35,8 %, 29,9 %, 43,2 % et 90,5 % respectivement pour les femmes classées dans les
catégories 0, 1, 2 et 3 selon l'EOSS (P < 0,001). Un indice global ne s'est pas avéré révélateur du taux global d'événements
défavorables maternels, obstétricaux et néonataux (P = 0,22).
Conclusion
L'EOSS pourrait aider à prédire la probabilité d'accouchement par césarienne dans
un groupe à risque élevé de femmes nullipares en surpoids ou atteintes d'obésité en
cas de déclenchement artificiel du travail d'une grossesse à terme.
Key Words
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Article info
Publication history
Published online: December 18, 2019
Accepted:
August 15,
2019
Received:
February 19,
2019
Footnotes
Competing interests: See Acknowledgements.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
