Maternal Obesity as a Risk Factor for Caesarean Delivery in Sub-Saharan Africa: A Systematic Review

Brizan, Jessica B.; Amabebe, Emmanuel

doi:10.3390/life12060906

Cited by 4 publications

(5 citation statements)

References 53 publications

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“…In the last few years, several epidemiological studies have supported that the rising rates of caesarean sections may be associated with specific maternal risk factors. In support of this view, prepregnancy maternal obesity has been considered as a significant risk factor for caesarean delivery, even if some studies were characterized by certain limitations [13,14]. Moreover, mothers' age lower than 30 years was shown to decrease the risk of comorbidities related with caesarean section, whereas older maternal age, i.e., 35 years or more, was shown to considerably enhanced the rate of caesarean sections and their adverse outcomes [15].…”

Section: Introductionmentioning

confidence: 99%

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Pavlidou,

Papadopoulou,

Alexatou

et al. 2023

Preprint

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Background: There is an exponential increase in caesarean sections with epidemic proportions worldwide, which is considered as a serious public health issue that influences negatively both maternal and childhood health. Aims: This study aimed to evaluate the associations between pre-dominant maternal risk factors and the prevalence of caesarean section in a representative sample of women from Greece. Methods: This is a cross-sectional study conducted on 5182 healthy, re-productive-aged women from 11 geographically diverse Greek areas after applying specific inclu-sion and exclusion criteria. Statistical analysis was applied to evaluate the impact of maternal so-ciodemographic, anthropometric, lifestyle and perinatal factors in the risk of caesarean section de-liveries. Results: A high prevalence of 56.4% of caesarean section deliveries was recorded in the study population. The incidence of caesarean sections reached to 51.5% in private hospitals in which an increasing rate of 47.5% for planned caesarean sections were noticed. Older maternal age, pre-pregnancy overweight and obesity, excess gestational weight gain, high rates of preterm birth, better economic status, smoking habits, and private type of birth hospital were significantly related with enhanced risk of caesarean section, independently of multiple confounding factors. Conclu-sions: Our study revealed that caesarean section rates are continuously increase, while several maternal risk factors, including especially pre-pregnancy overweight/obesity and excess gestational weight gain, cumulatively raise its prevalence which further increase the risk for postnatal adverse outcomes for both the mothers and their children. Emergent public health policies and strategies should be promoted to confront the predominant maternal risk factors-related with caesarean sec-tion and inform future mothers how to be prevented from them by applying healthier nutritional and lifestyle habits and to select caesarean section only due to emergency medical reasons. Alarmingly enough, targeted nutritional intervention strategies are strongly recommended to ef-fectively reduce the prevalence of maternal pre-pregnancy overweight/obesity and the excess gestational weight gain, which in turn may minimize the risk of childhood overweight/obesity.

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Section: Introductionmentioning

confidence: 99%

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Pavlidou,

Papadopoulou,

Alexatou

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In the last few years, several epidemiological studies have supported that the rising rates of caesarean sections could be related with specific mothers’ risk factors. In support of this view, maternal excessive body weight prior to gestation has been considered as a significant risk factor of increasing the possibility of undergoing caesarean delivery, even if some studies were characterized by certain limitations [ 13 , 14 ]. Moreover, mothers’ age lower than 30 years was shown to decrease the risk of comorbidities related with caesarean section, whereas older mothers’ age, i.e., 35 years or above, has been shown to considerably enhance the rates of caesarean sections and their complications [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study

Pavlidou,

Antasouras,

Papadopoulou

et al. 2023

Medical Sciences

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In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers’ and children’s health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

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“…[2] MO rates > 40.0% have been reported in sub-Saharan Africa. [2,3] In Asia, the prevalence of MO has been reported to be over 20.0% in Malaysia and even higher than 40.0% in India. [4,5] The prevalence of MO is over 20.0% in Europe, [6,7] while the prevalence of obesity in reproductive age women is at least 31.8% in the United States of America.…”

Section: Introductionmentioning

confidence: 99%

“…[10] These include preeclampsia, fetal growth restriction (FGR), preterm birth (PTB), and caesarean delivery. [3,11,12] Obesity is also characterized by low-grade systemic inflammation, altered gut microbiota, insulin resistance and hyperglycemia, which are metabolic syndrome-like features similar to those seen in diabetes mellitus. [13] MO and associated inflammation and insulin resistance can, therefore, lead to gestational diabetes mellitus (GDM) and consequently placental dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Maternal obesity-related placental dysfunction: From peri-conception to late gestation

Amabebe

Ikumi

Pillay

et al. 2023

PRM

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Obesity is a global epidemic with alarmingly high prevalence rates worldwide. The increasing incidence of obesity among reproductive age women, which progresses to obesity in pregnancy is of particular concern. A successful pregnancy is dependent on the balanced interaction between maternal cardiometabolic function, genetic predisposition, and optimal placental development. Maternal obesity, both pre-pregnancy and gestational, has been associated with adverse outcomes including poor fetal development, stillbirth, preterm birth, and metabolic complications later in life. To gain a more comprehensive understanding of the mechanistic interplay of key mediators of obesity-associated placental dysfunction and adverse pregnancy outcomes, we conducted a review of 24 studies that investigated placental dysfunction and maternal obesity retrieved from MEDLINE, LILACS and EMBASE. The findings demonstrate that maternal obesity is a well-established risk factor for poor placental function. Pre-pregnancy obesity alters the placental transcriptome. Maternal obesity during gestation induces changes in placental morphology, dysregulated placental metabolism, inflammation and oxidative state, as well as endothelial dysfunction. There is also clear evidence that maternal obesity is associated with altered placental angiogenesis/vascularisation which increases the risk of early-onset preeclampsia. Studies show a link between maternal obesity and increased placental vascular disorders, placental weight, placental volume and birth weight. These obesity-related placental disorders are often associated with insulin resistance and gestational diabetes mellitus.

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Maternal Obesity as a Risk Factor for Caesarean Delivery in Sub-Saharan Africa: A Systematic Review

Cited by 4 publications

References 53 publications

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Predominant Maternal Risk Factors Increase the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study in a Reproductive-Aged Women Population

Association of Maternal Risk Factors with the Prevalence of Caesarean Section Deliveries: A Cross-Sectional Study

Maternal obesity-related placental dysfunction: From peri-conception to late gestation

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