{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:24:27Z","timestamp":1785414267942,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study investigates associations between maternal body mass index (BMI) early in pregnancy and obstetric interventions, maternal and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a cohort study of nulliparous women originally included in a cluster randomized controlled trial carried out at 14 Norwegian obstetric units between 2014 and 2017. The sample included 7189 nulliparous women with a singleton fetus, cephalic presentation and spontaneous onset of labor at term, denoted as group 1 in the Ten\u2010Group Classification System. The women were grouped according to the World Health Organization BMI classifications: underweight (BMI\u00a0&lt;18.5), normal weight (BMI 18.5\u201024.9), pre\u2010obesity (BMI 25.0\u201029.9), obesity class I (BMI 30.0\u201034.9), and obesity classes II and III (BMI\u00a0\u226535.0). We used binary logistic regression to estimate crude and adjusted odds ratios (ORs) of the interventions and outcomes, with associated 95% confidence intervals (CIs), comparing women in different BMI groups with women of normal weight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found an increased risk of intrapartum cesarean section in women of obesity class I and obesity classes II and III, with adjusted OR of 1.70 (95% CI 1.21\u20102.38) and 2.31 (95% CI 1.41\u20103.77), respectively. Women in obesity groups had a gradient of risk of epidural analgesia and use of continuous CTG (including STAN), with adjusted OR of 2.39 (95% CI 1.69\u20103.38) and 3.28 (95% CI 1.97\u20105.48), respectively. Women in obesity classes II and III had higher risk of amniotomy (adjusted OR\u00a0=\u00a01.42, 95% CI 1.02\u20101.96), oxytocin augmentation (adjusted OR\u00a0=\u00a01.54, 95% CI 1.11\u20102.15), obstetric anal sphincter injuries (adjusted OR\u00a0=\u00a02.21, 95% CI 1.01\u20104.85) and postpartum hemorrhage\u00a0\u22651000\u00a0mL (adjusted OR\u00a0=\u00a02.20, 95% CI 1.29\u20103.78). We found a reduced likelihood of spontaneous vaginal delivery for pre\u2010obese women (adjusted OR\u00a0=\u00a00.85, 95% CI 0.74\u20100.97) and no associations between maternal BMI and neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obese women in Ten\u2010Group Classification System group 1 had increased risks of obstetric interventions and maternal complications. There was a gradient of risk for intrapartum cesarean section, with the highest risk for women in obesity classes II and III. No associations between maternal BMI and neonatal outcomes were observed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14017","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T18:45:59Z","timestamp":1602182759000},"page":"521-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Maternal body mass index and risk of obstetric, maternal and neonatal outcomes: A cohort study of nulliparous women with spontaneous onset of labor"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0522-0526","authenticated-orcid":false,"given":"Rebecka","family":"Dalbye","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00d8stfold Hospital Trust Gr\u00e5lum Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Gunnes","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Women\u2019s Health Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Blix","sequence":"additional","affiliation":[{"name":"Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet \u2010 Oslo Metropolitan University Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3162-9595","authenticated-orcid":false,"given":"Torbj\u00f8rn","family":"Eggeb\u00f8","sequence":"additional","affiliation":[{"name":"National Center for Fetal Medicine St. Olav\u2019s Hospital Trondheim University Hospital Trondheim Norway"},{"name":"Department of Obstetrics and Gynecology Stavanger University Hospital Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linn","family":"Nistov Tokheim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Vestfold Hospital Trust T\u00f8nsberg Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7391-5311","authenticated-orcid":false,"given":"P\u00e5l","family":"\u00d8ian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital of North Norway Norway, Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine","family":"Bernitz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00d8stfold Hospital Trust Gr\u00e5lum Norway"},{"name":"Department of Nursing and Health Promotion Faculty of Health Sciences OsloMet \u2010 Oslo Metropolitan University Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO (World Health Organization).Obesity and overweight. 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