Association Between Pre-Pregnancy Body Mass Index and Labor Induction Success Rates: A Case Control Study

BACKGROUND Obesity is described as excessive fat accumulation. Almost 47% of pregnant women gain more weight than recommended. The prevalence of obesity doubled from 2007 to 2018 (10.5% to 21.8%) in Indonesia. An increase in body mass index (BMI) before pregnancy is associated with delayed labor and vaginal delivery failure. Women with overweight or obesity in pregnancy are at increased risk of developing gestational hypertension and gestational diabetes, resulting in the induction of labor or elective cesarean section. This study aimed to investigate the correlation between pre-pregnancy BMI and outcomes from induction of labor in 248 women during 1 year at a hospital in Purwokerto, Indonesia. MATERIAL AND METHODS The study was conducted at Margono Soekarjo General Hospital and involved all pregnant women delivered between 2023 and 2024. Inclusion and exclusion criteria were applied. Total number of pregnant women was 248, BMI used Asian parameters, induction of labor was performed with oxytocin or misoprostol, and outcomes were according to the International Federation of Gynecology and Obstetrics. The design was a case-control study. Statistical analysis performed using IBM SPSS Statistics version 29.0.1.0 was used to analyze odds ratio and chi-square test. RESULTS This research study revealed pregnant women with obesity had statistically significant higher odds, with an odds ratio of 3.78 (95% CI 1.53-9.31, P=0.002), of labor induction failure than did those without obesity. CONCLUSIONS The findings from this study showed that increased BMI in pre-pregnancy significantly increased the risk of failure of labor induction.