ArticleEuropean journal of obstetrics & gynecology and reproductive biology: X2026
Planned vaginal birth with epidural analgesia in obese women: Effects on maternal and fetal outcomes. A retrospective cohort study.
Article in European journal of obstetrics & gynecology and reproductive biology: X, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Obese pregnant women (body mass index ≥ 30 kg/m Methods: Patient records of obese women undergoing a planned vaginal delivery from January 2018 until December 2023 in a tertiary care center were screened. Women were stratified into two groups depending on whether or not they received EA during their deliveries. EA was provided after shared decision making between provider and mother. Baseline characteristics and perinatal outcomes were collected for both groups. Primary outcomes were conversion to cesarean section (CS) and reduced Apgar scores (<7 at 5 min). Secondary outcomes were mode of delivery, type of anesthesia, estimated blood loss, episiotomies, perineal ruptures, hospital length of stay, fetal umbilical artery pH and base excess. Using inverse probability of treatment weights, primary outcomes per group were adjusted for baseline characteristics in a logistic regression model. Results: 259 women received EA, 144 did not. Women with EA had lower gravidity and parity, more often induction of labor and delivered children with higher birthweights. In total 88 (22%) women in both groups required secondary CS. General anesthesia was avoided for all 64 women with EA. In the non-EA group, general anesthesia was used for seven out of 24 women. After adjustment, conversion to CS (OR 0.984, CI 0.542-1.786, P = 0.957) and reduced Apgar scores (OR 1.138, CI 0.375-3.458, P = 0.820) were not significantly different. Secondary outcomes (unadjusted) showed several differences. EA was associated with more vacuum deliveries (16% vs 2%, P < 0.001), more episiotomies (18% vs 7%, P = 0.003), higher mean blood loss (523 ml vs 351 ml, P < 0.001), and longer mean length of hospital admittance (4.3 days vs 3.5, P < 0.001). Conclusions: Women with a BMI ≥ 30 kg/m
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