Labor Induction in Obese Pregnancies at Term: Risk Factors and Pregnancy Outcomes
Huwaida Nabilah1,2, Hermanto Tri Joewono1,3, Muhammad Ilham Aldika Akbar1,3
1Department Obstetrics & Gynecology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia.
Journal of Pregnancy
|March 31, 2026
Summary
For obese pregnancies at term, first-time mothers, unfavorable cervix status, and excessive weight gain increase the risk of failed labor induction. These factors are linked to adverse maternal and neonatal outcomes, necessitating careful patient selection and counseling.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Reproductive Health
Background:
- Obesity in pregnancy (BMI ≥ 30 kg/m²) presents unique challenges for labor induction.
- Understanding factors predicting labor induction failure is crucial for optimizing outcomes in this high-risk group.
Purpose of the Study:
- To identify risk factors for failed labor induction in obese women at term.
- To evaluate maternal and neonatal outcomes associated with labor induction failure in obese pregnancies.
Main Methods:
- Cross-sectional study of 159 obese women undergoing labor induction at 37-41 weeks' gestation.
- Comparison of maternal characteristics, induction factors, and outcomes between successful and failed induction groups.
- Multivariable logistic regression to determine independent risk factors for induction failure.
Main Results:
- Failed induction (n=53) was associated with primiparity (aOR 3.10), Bishop score < 3 (aOR 2.02), and higher maternal weight gain (aOR 0.89 per kg).
- Failed induction correlated with increased severe preeclampsia (18.9% vs 1.9%) and 100% cesarean delivery rate.
- No significant differences in 5-min Apgar scores, fetal growth restriction, congenital anomalies, or NICU admissions were observed.
Conclusions:
- Primiparity, unfavorable cervical status, and excessive gestational weight gain are independent predictors of failed labor induction in obese term pregnancies.
- These findings underscore the need for careful patient selection and cervical assessment to improve outcomes.
- Anticipatory counseling regarding potential induction challenges is recommended for obese pregnant individuals.
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