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The Edmonton Obesity Staging System Predicts Mode of Delivery After Labour Induction

Published:December 18, 2019DOI:https://doi.org/10.1016/j.jogc.2019.08.022

      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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