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NEW YORK (Reuters Health), Nov 5, 2004
Past research has shown that
obese women undergo cesarean sections at about twice as often
as normal-weight women, but
the reasons are not fully clear. The new findings suggest that
overweight women's typically slower labor is one factor.
The
study, of 612 women seen in North Carolina prenatal clinics,
found that those with a pre-pregnancy body mass index (BMI)
that fell into the overweight or obese category typically spent
more than an hour longer in one of the stages of labor.
The
findings suggest that a woman's pre-pregnancy weight should
be a factor in the decision on whether to do a C-section, according
to the study's lead author, Dr. Anjel Vahratian of the University
of Michigan at Ann Arbor.
"Overweight women might just have
a generally longer labor," she told Reuters Health. Therefore,
if a heavier woman's labor seems to be progressing slowly,
Vahratian said, her obstetrician may want to "let her go a
bit longer" before opting to do a C-section.
For their study,
which is published in the journal Obstetrics & Gynecology,
Vahratian and her colleagues focused on women's progression
during the "active" part of the first stage of labor, when
the cervix dilates from 4 to 10 centimeters.
They found that
while women with a healthy pre-pregnancy BMI typically spent
just over 6 hours in this part of labor, overweight and obese
women took 7.5 to 8 hours to progress through it.
Pre-pregnancy
BMI was linked to longer labor even when other factors were
considered -- including the baby's birth size, the mother's
weight gain during pregnancy, and epidural use during labor.
The reason for the slower labor progression is uncertain, but
may have to do with excess fat hindering the widening of the
birth canal, Vahratian and her colleagues speculate.
The findings
add to the list of pregnancy and labor problems for which overweight
women are at greater risk. Besides their higher rate of C-section,
heavy women are more likely to develop gestational diabetes
or high blood pressure during pregnancy, and are more likely
to deliver abnormally large infants.
It's important, Vahratian
said, for women of childbearing age to maintain a healthy diet
and regularly exercise, so that they can have the "best possible
nutritional status" going into pregnancy.
In the U.S., about
half of all women of reproductive age are overweight or obese,
Vahratian and her colleagues note in their report. In addition,
she said, many women -- thin and heavy alike-gain much more
weight during pregnancy than is recommended. And those excess
pounds can be hard to shed later.
Experts advise that normal-weight
women gain 25 to 35 pounds over the course of pregnancy, while
those who are overweight should put on 15 to 25 pounds. Women
should not attempt to lose weight while they're pregnant.
SOURCE: Obstetrics & Gynecology, November 2004.
© Copyright
Reuters 2004
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