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Maternal Body Mass Index and Use of Labor Neuraxial Analgesia: A Population-Based Retrospective Cohort Study.
Abstract Number: T2A-2
Abstract Type: Original Research
Background: Neuraxial labor analgesia is recommended for obese parturients in labor. However, it is unclear whether rates of neuraxial labor analgesia differ according to maternal body mass index (BMI).
Methods: Using United States vital statistics data, we conducted a cohort study of women who underwent a trial of labor between 2009 and 2015. We performed multivariable logistic regression to examine the relationships between BMI class and receipt of neuraxial labor analgesia.
Results: The study cohort comprised 17,220,680 women; 0.1% were underweight, 12.7% were normal BMI, 37% were overweight, 28.3%, 13.5%, and 8.4% were obesity class I, II, and III, respectively. The unadjusted and adjusted rates of neuraxial labor analgesia according to BMI class are presented in the Figure. Compared to normal BMI women, the unadjusted rate was lowest among underweight women (59.7%) and highest among women in obesity class III (75.6%) (P <0.001, respectively). After adjustment, the rates of neuraxial labor analgesia remained lowest for underweight women (65.1%) and highest in the obesity class III women (73.1%) compared to normal BMI women (P<0.001, respectively) (Figure). In our multivariable analyses, compared to women with normal BMI, the risk of receiving neuraxial labor analgesia was slightly increased for overweight women (adjusted relative risk (aRR) 1.02; 95% confidence intervals (CI) 1.02 to 1.02), obese class I (aRR 1.04; 95% CI 1.04 to 1.04), obese class II (aRR 1.05; 95% CI 1.05 to 1.05), and obese class III (aRR 1.06; 95% CI 1.06 to 1.06).
Conclusion: Our findings suggest that the likelihood of receiving neuraxial labor analgesia is only marginally increased for morbidly obese women compared to women with normal BMI. Future studies are needed to assess whether neuraxial labor analgesia influences the risk of obstetric morbidity in this population.