Difficult calving may adversely affect dairy cow health and performance. Maternal:fetal disproportion is a major cause of dystocia. Therefore, the main objective of this study was to assess the effects of dam:calf body weight ratio (D:C) on calving difficulty, rumination time, lying time, and inflammatory profile in 25 Holstein dairy cows. Using automatic monitoring systems, we monitored behavior and production in 9 primiparous and 16 pluriparous cows between dry-off and 30 d in milk. During the same period, we collected blood samples to monitor metabolism and inflammatory profile of these cows. Calvings were video recorded to assess calving difficulty and observe the duration of the expulsive stage. After parturition, the cows were separated into 3 classes according to their D:C: easy (E; D:C >17), medium (M; 14 < D:C