{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:23:01Z","timestamp":1762917781447},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Obesity in pregnancy is a growing health problem conferring higher risk to both the woman and her infant. Internationally, peak bodies offer little guidance regarding the method and timing of delivery in these patients. Our hypothesis is that induction of labour (<jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content>) at term will not increase the caesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) rate when compared to expectant management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare perinatal outcomes between <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> and expectant management in obese women at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of all term, singleton, vertex deliveries at the Townsville Hospital and Health Service from January 2011 to June 2015 in women with a body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) \u2265\u00a035. Women undergoing <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> at 37\u00a0weeks were compared with women expectantly managed at that gestational age. Similar comparisons were made at 38, 39 and 40\u00a0weeks. \u03c7<jats:sup>2<\/jats:sup> tests and binary logistic regression were used for statistical comparison. The primary outcome measure was mode of delivery, with secondary measures of perinatal morbidity also considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in outcome of <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>, or other maternal secondary outcomes. There was no difference in rates of neonatal nursery admission. Expectant management at 38\u00a0weeks was associated with lower odds of post\u2010partum haemorrhage (odds ratio 0.371; 95% confidence interval 0.163\u20130.845).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with a <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> \u2265\u00a035, <jats:styled-content style=\"fixed-case\">IOL<\/jats:styled-content> does not affect the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> rate, or the risk of neonatal adverse events, but may increase the rate of postpartum haemorrhage when compared with expectant management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12616","type":"journal-article","created":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T15:06:21Z","timestamp":1490367981000},"page":"440-445","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Caesarean risk in obese women at term: A\u00a0retrospective cohort analysis"],"prefix":"10.1111","volume":"57","author":[{"given":"Rachael","family":"Nugent","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Townsville Hospital  Douglas Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"de Costa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology James Cook University, College of Medicine, Cairns Clinical School, Cairns Hospital  Cairns City Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkat","family":"Vangaveti","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry James Cook University  Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.11120"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2011.05.015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00115.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000107291.46159.00"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00546.x"},{"key":"e_1_2_6_7_1","unstructured":"National Institute for Health and Clinical Excellence.Weight management before during and after pregnancy 2010. 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