IMPROVING CARE FOR INDIVIDUALS WITH HIGHER BODY MASS INDEX (BMI) UNDERGOING INDUCTION TERMINATION

Abstract

Objectives

We aimed to examine the association of body mass index (BMI) with time to delivery for those undergoing induction of labor for pregnancy termination in the second or third trimester.

Methods

This is a retrospective cohort study including all patients with a singleton pregnancy undergoing induction termination at a single academic medical center over a 14-year period (1/2020-2/2024). Our primary outcome was time to fetal expulsion from the first medication given. BMI was categorized into four groups (<18.5, 18.5-25, 25-30, and >30). Kruskal-Wallis tests were used to compare median time to delivery among the BMI groups; and multivariable logistic regression models were used to assess the association of BMI with time to delivery ≥24 hours.

Results

Of the 428 charts reviewed, 393 patients met inclusion criteria. Of these, 290 (73.7%) had a BMI greater than 25. The median time to expulsion was significantly different among BMI categories (9 hours for BMI < 18.5, 12 hours for BMI 18.5-25, 14 hours for BMI 25-30, and 20 hours for individuals with BMI >30, p<0.001). After adjusting for maternal age, gestational age, history of cesarean section and prior vaginal deliveries, individuals with a BMI >30 had 6.74 times the odds (95%CI 3.24-14.00) of having a time to expulsion ≥24 hours compared to BMI 18.5-25.

Conclusions

We found individuals had a significantly longer time to delivery in second and third trimester induction terminations for patients with BMI >30. Induction protocols may need to be adjusted to provide equitable care for individuals with higher BMI.