Birth complications, overweight, and physical inactivity

Objective. Maternal lifestyle factors are potential predictors of pregnancy complications. We examined relations between modifiable factors and delivery complications. Design. Prospective cohort. Setting. University hospital antenatal clinic, Oslo, Norway. Sample. A cohort of 553 women followed through pregnancy and delivery. Main outcome measures. Pre-specified birth complications: cesarean section (CS), operative vaginal deliveries (VDs), third and fourth degree of perineal lacerations and hemorrhage (]1,000 ml). Methods. Univariate and multiple logistic regression analyses were performed. Besides high birthweight (]4,200 g), modifiable predictors (high body mass index (BMI), fasting glucose and physical inactivity) and non-modifiable predictors (parity, maternal age, gestational age, and gender) were considered. Results. Significant predictors for induction of labor were parity (odds ratio (OR): 2.1; 95% CI 1.3 3.5), maternal age (OR: 2.0; 1.2 3.4), gestational age (OR: 1.9; 1.1 3.1), and BMI ]30 (OR: 4.2; 2.2 7.8, pB0.01). High birthweight and high BMI were overrepresented among CSs. Emergency CS was associated with birthweight (OR: 3.7; 1.7 8.1), parity (OR: 3.5; 1.7 7.2), maternal age (OR: 2.6; 1.3 5.3), and induction of labor (OR: 4.8; 2.6 9.1). After excluding CS, operative VD was associated with parity (OR: 8.7; 3.8 20) and gender (OR: 2.2; 1.2 14.1). Perineal laceration was associated with pregestational physical inactivity (OR: 6.1; 1.6 22.9) and operative VD (OR: 5.1; 1.5 17.6). Hemorrhage was associated with high birthweight (OR: 4.2; 1.2 4.7) and BMI ]30 (OR: 4.6; 1.2 17.7). Conclusions. Pre-gestational physical inactivity increased the risk of perineal lacerations and male infants were associated with higher risk of vaginal operative delivery