{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:01:00Z","timestamp":1791158460866,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,12,17]],"date-time":"2004-12-17T00:00:00Z","timestamp":1103241600000},"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":["BJOG"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:p><jats:bold>Objective\u2003<\/jats:bold> To show the increased risk of adverse outcomes in labour and fetomaternal morbidity in obese women (BMI &gt; 30).<\/jats:p><jats:p><jats:bold>Design\u2003<\/jats:bold> A population\u2010based observational study.<\/jats:p><jats:p><jats:bold>Setting\u2003<\/jats:bold> University Hospital of Wales. The study sample was drawn from the Cardiff Births Survey, a population\u2010based database comprising of a total of 60,167 deliveries in the South Glamorgan area between 1990 and 1999.<\/jats:p><jats:p><jats:bold>Population\u2003<\/jats:bold> Primigravid women with a singleton uncomplicated pregnancy with cephalic presentation of 37 or more weeks of gestation with accurate information regarding height and weight recorded at the booking visit (measured by the midwives) were included in the study.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold> Comparisons were made between women with a body mass index of 20\u201330 and those with more than 30. SPSS version 10 was used for statistical analysis. Student's <jats:italic>t<\/jats:italic> test, \u03c7<jats:sup>2<\/jats:sup> and Fisher's exact tests were used wherever appropriate.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2003<\/jats:bold> Labour outcomes assessed were risk of postdates, induction of labour, mode of delivery, failed instrumental delivery, macrosomia and shoulder dystocia. Maternal adverse outcomes assessed were postpartum haemorrhage, blood transfusion, uterine and wound infection, urinary tract infection, evacuation of uterus, thromboembolism and third\u2010 or fourth\u2010degree perineal tears. Fetal wellbeing was assessed using Apgar &lt;7 at 5 minutes, trauma and asphyxia, cord pH &lt; 7.2, babies requiring neonatal ward admissions, tube feeding and incubator.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> We report an increased risk [quoted as odds ratio (OR) and confidence intervals CI)] of postdates, 1.4 (1.2\u20131.7); induction of labour, 1.6 (1.3\u20131.9); caesarean section, 1.6 (1.4\u20132); macrosomia, 2.1 (1.6\u20132.6); shoulder dystocia, 2.9 (1.4\u20135.8); failed instrumental delivery, 1.75 (1.1\u20132.9); increased maternal complications such as blood loss of more than 500 mL, 1.5 (1.2\u20131.8); urinary tract infections, 1.9 (1.1\u20133.4); and increased neonatal admissions with complications such as neonatal trauma, feeding difficulties and incubator requirement.<\/jats:p><jats:p><jats:bold>Conclusion\u2003<\/jats:bold> Obese women appear to be at risk of intrapartum and postpartum complications. Induction of labour appears to be the starting point in the cascade of events. They should be considered as high risk and counselled accordingly.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2004.00546.x","type":"journal-article","created":{"date-parts":[[2005,6,1]],"date-time":"2005-06-01T15:48:57Z","timestamp":1117640937000},"page":"768-772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":356,"title":["Outcome of pregnancy in a woman with an increased body mass index"],"prefix":"10.1111","volume":"112","author":[{"given":"T.S.","family":"Usha Kiran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hemmadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Bethel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,4,20]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"BBC News"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pu.07.050186.002425"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801670"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200143"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/1520-6661(200007\/08)9:4<238::AID-MFM10>3.3.CO;2-X"},{"issue":"2","key":"e_1_2_6_7_2","first-page":"95","article-title":"Complications and outcome of pregnancy in obese women","volume":"5","author":"Tilton Z","year":"1989","journal-title":"Nutrition"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.117351"},{"key":"e_1_2_6_9_2","volume-title":"Managing Complication in Pregnancy and Childbirth, a Guide for Midwives and Doctors","year":"2000"},{"key":"e_1_2_6_10_2","first-page":"338","volume-title":"The Confidential Enquiries into Maternal Deaths in the United Kingdom","author":"Bottling B","year":"2001"},{"issue":"4","key":"e_1_2_6_11_2","first-page":"446","article-title":"Obesity in pregnancy: risks and outcome","volume":"56","author":"Gross T","year":"1980","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)90705-V"},{"key":"e_1_2_6_13_2","volume-title":"Obesity Among People Aged 16 and Over 1998"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0800750"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000107291.46159.00"},{"issue":"5","key":"e_1_2_6_16_2","first-page":"431","article-title":"Maternal obesity and pregnancy","volume":"164","author":"Johnson SR","year":"1987","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6661(199807\/08)7:4<190::AID-MFM5>3.0.CO;2-D"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(12)80019-6"},{"issue":"1","key":"e_1_2_6_19_2","first-page":"61","article-title":"Maternal weight, and fetal injury at birth: data deriving from medico\u2010legal research","volume":"17","author":"Sama JC","year":"1998","journal-title":"Med Law"},{"issue":"2","key":"e_1_2_6_20_2","first-page":"158","article-title":"Macrosomia\u2010maternal characteristics and infant complications","volume":"66","author":"Spellacy WN","year":"1985","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127125"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)01078-4"},{"key":"e_1_2_6_23_2","volume-title":"National Sentinal Caesarean Section Audit","year":"2001"},{"issue":"1","key":"e_1_2_6_24_2","first-page":"10","article-title":"Obstetric challenges of massive obesity complicating pregnancy","volume":"14","author":"Isaacs JD","year":"1994","journal-title":"J Perinatol"},{"issue":"2","key":"e_1_2_6_25_2","first-page":"CD00080","article-title":"Energy\/protein restriction for high weight\u2010for\u2010height or weight gain during pregnancy","author":"Kramer MS","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_26_2","first-page":"261","volume-title":"The Confidential Enquiries into Maternal Deaths in the United Kingdom","author":"Carson C","year":"2001"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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