The relationship between body mass index and perceived control over labor.


Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
25 Oct 2023
Historique:
received: 05 07 2023
accepted: 12 10 2023
medline: 27 10 2023
pubmed: 26 10 2023
entrez: 25 10 2023
Statut: epublish

Résumé

Individuals with an increased body mass index (BMI) (≥ 30 kg/m2) experience higher rates of perinatal mental health disorders than individuals with BMI < 30. Personal experience of decreased control over labor has been associated with the development postpartum mood and anxiety disorders. However, no studies have investigated the association between BMI and experience of control over labor. This study aimed to assess perceived control over labor and compare patients with BMI ≥ 30 to those with BMI < 30. We performed a secondary analysis of a cross-sectional study of postpartum patients who delivered at term (37-41 weeks gestation). Postpartum, participants completed the Labour Agentry Scale (LAS), a validated tool to assess perceived control over labor/birth. Demographic, maternal health history and obstetric/neonatal outcomes were abstracted from the patient chart. Bivariate analyses were performed between those with BMI < 30 and those with BMI ≥ 30 using Fisher's exact test. Continuous LAS scores were compared between patients with BMI < 30 and BMI ≥ 30 using Wilcoxon rank-sum tests. Higher LAS scores indicate higher perceived control over labor. Multivariable linear regression was then performed to account for confounding factors identified a priori. There was no difference in LAS between those with BMI ≥ 30 and BMI < 30. When stratified by World Health Organization (WHO) class of BMI, those with BMI ≥ 40 had a significantly lower LAS scores than those with BMI < 30 (147 vs. 163, p = 0.02), however, this finding was no longer significant after controlling for length of labor and cesarean birth. Only participants with the highest BMI experienced decreased control over labor, and this finding was no longer significant after controlling for mode of delivery and length of labor. Further research into the experience of birthing people with BMI ≥ 30 is critical to understand the increased risk of perinatal mood disorders among this population.

Sections du résumé

BACKGROUND BACKGROUND
Individuals with an increased body mass index (BMI) (≥ 30 kg/m2) experience higher rates of perinatal mental health disorders than individuals with BMI < 30. Personal experience of decreased control over labor has been associated with the development postpartum mood and anxiety disorders. However, no studies have investigated the association between BMI and experience of control over labor. This study aimed to assess perceived control over labor and compare patients with BMI ≥ 30 to those with BMI < 30.
METHODS METHODS
We performed a secondary analysis of a cross-sectional study of postpartum patients who delivered at term (37-41 weeks gestation). Postpartum, participants completed the Labour Agentry Scale (LAS), a validated tool to assess perceived control over labor/birth. Demographic, maternal health history and obstetric/neonatal outcomes were abstracted from the patient chart. Bivariate analyses were performed between those with BMI < 30 and those with BMI ≥ 30 using Fisher's exact test. Continuous LAS scores were compared between patients with BMI < 30 and BMI ≥ 30 using Wilcoxon rank-sum tests. Higher LAS scores indicate higher perceived control over labor. Multivariable linear regression was then performed to account for confounding factors identified a priori.
RESULTS RESULTS
There was no difference in LAS between those with BMI ≥ 30 and BMI < 30. When stratified by World Health Organization (WHO) class of BMI, those with BMI ≥ 40 had a significantly lower LAS scores than those with BMI < 30 (147 vs. 163, p = 0.02), however, this finding was no longer significant after controlling for length of labor and cesarean birth.
CONCLUSION CONCLUSIONS
Only participants with the highest BMI experienced decreased control over labor, and this finding was no longer significant after controlling for mode of delivery and length of labor. Further research into the experience of birthing people with BMI ≥ 30 is critical to understand the increased risk of perinatal mood disorders among this population.

Identifiants

pubmed: 37880671
doi: 10.1186/s12884-023-06063-w
pii: 10.1186/s12884-023-06063-w
pmc: PMC10598931
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

752

Subventions

Organisme : NICHD NIH HHS
ID : K23 HD103961
Pays : United States

Commentaires et corrections

Type : UpdateOf

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Anna R Whelan (AR)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women &, Infants Hospital of Rhode Island, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI, 02905, USA. anna.whelan.md@gmail.com.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA. anna.whelan.md@gmail.com.

Brock E Polnaszek (BE)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women &, Infants Hospital of Rhode Island, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI, 02905, USA.

Olivia Recabo (O)

Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, USA.

Melissa A Clark (MA)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women &, Infants Hospital of Rhode Island, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI, 02905, USA.

Adam K Lewkowitz (AK)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women &, Infants Hospital of Rhode Island, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI, 02905, USA.

Nina K Ayala (NK)

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women &, Infants Hospital of Rhode Island, Alpert Medical School of Brown University, 101 Dudley St, Providence, RI, 02905, USA.

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Classifications MeSH