# Antibiotic Prophylaxis to Prevent Obesity-related Induction Complications in Nulliparae at Term (APPOINT 2.0)

> **NIH NIH R01** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $677,083

## Abstract

Project Summary/Abstract
Obesity increases the risk of pregnancy complications, including puerperal infections and cesarean delivery,
and risk rises with increasing body mass index (BMI). Since obese women are more likely to have
comorbidities that would necessitate delivery prior to their due date (i.e. prior to 40 weeks gestation), and class
III obesity specifically is an indication for delivery by 39 weeks, these patients have a high rate of labor
induction. In nulliparous women from the general population (obese and non-obese), labor induction at 39
weeks (compared to expectant management) is associated with less maternal morbidity and a lower cesarean
rate. We previously conducted a pilot randomized placebo-controlled trial in obese, nulliparous women
undergoing labor induction at term and found that the cesarean delivery rate was lower in women who received
a prophylactic antibiotic regimen during labor compared with those who received the placebo. Our proposed
multi-center trial aims to test this hypothesis in a large sample with adequate power to determine whether
prophylactic antibiotics during labor are associated with a decrease in the rate of cesarean delivery in term,
nulliparous, obese women. If the findings from the pilot trial are confirmed, this would represent a novel
intervention to decrease the cesarean delivery rate in a subset of women at highest risk for cesarean-related
complications.

## Key facts

- **NIH application ID:** 10980684
- **Project number:** 1R01HD113755-01A1
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Stephanie Pierce
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $677,083
- **Award type:** 1
- **Project period:** 2024-09-17 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10980684

## Citation

> US National Institutes of Health, RePORTER application 10980684, Antibiotic Prophylaxis to Prevent Obesity-related Induction Complications in Nulliparae at Term (APPOINT 2.0) (1R01HD113755-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10980684. Licensed CC0.

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