Titration of Intravenous Oxytocin Infusion for Postdates Induction of Labor Across Body Mass Index Groups

May 23, 2017Journal of obstetric, gynecologic, and neonatal nursing : JOGNN

Adjusting Intravenous Oxytocin Dosage for Labor Induction After Due Date in Different Body Weight Groups

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Abstract

Women who were obese received 7.50 units of oxytocin compared to 5.92 units for overweight women during postdates labor induction.

A significant increase in the amount of oxytocin administered was observed in obese women compared to overweight women.
The time between rate changes in oxytocin administration was longer for overweight women than for obese women.
Length of labor was associated with increasing body mass index (BMI), with normal weight women experiencing a mean labor duration of 13.96 hours compared to 18.30 hours for obese women.
The rate of cesarean births increased with BMI: 4.8% for normal weight, 33.6% for overweight, and 42.4% for obese women.

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OBJECTIVE: To evaluate whether oxytocin titration for postdates labor induction differs among women who are normal weight, overweight, and obese and whether length of labor and birth method differ by oxytocin titration and body mass index (BMI).

DESIGN: Retrospective cohort study.

SETTING: U.S. university-affiliated hospital.

PARTICIPANTS: Of 280 eligible women, 21 were normal weight, 134 were overweight, and 125 were obese at labor admission.

METHODS: Data on women who received oxytocin for postdates induction between January 1, 2013 and June 30, 2013 were extracted from medical records. Oxytocin administration and labor outcomes were compared across BMI groups, controlling for potential confounders. Data were analyzed using χ, analysis of variance, analysis of covariance, and multiple linear and logistic regression models. 2

RESULTS: Women who were obese received more oxytocin than women who were overweight in the unadjusted analysis of variance (7.50 units compared with 5.92 units, p = .031). Women who were overweight had more minutes between rate changes from initiation to maximum than women who were obese (98.19 minutes compared with 83.39 minutes, p = .038). Length of labor increased with BMI (p = .018), with a mean length of labor for the normal weight group of 13.96 hours (standard deviation = 8.10); for the overweight group, 16.00 hours (standard deviation = 7.54); and for the obese group, 18.30 hours (standard deviation = 8.65). Cesarean rate increased with BMI (p = .001), with 4.8% of normal weight, 33.6% of overweight, and 42.4% of obese women having cesarean births.

CONCLUSION: Women who were obese and experienced postdates labor induction received more oxytocin than women who were non-obese and had longer length of labor and greater cesarean rates.

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Titration of Intravenous Oxytocin Infusion for Postdates Induction of Labor Across Body Mass Index Groups

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