Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta‐analysis of cohort studies

Poobalan, Amudha; Aucott, Lorna; Gurung, Tara; Smith, W. C.; Bhattacharya, Sohinee

doi:10.1111/j.1467-789x.2008.00537.x

Cited by 338 publications

(249 citation statements)

References 22 publications

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“…Overweight and obese mothers, and mothers with excessive weight gain, were at increased risk of Caesarean delivery. This is in line with observations in other studies that examined the association of maternal obesity and antenatal complications (16)(17)(18)27). These associations might be influenced by the effect of obesity and excessive gestational weight gain on birth weight.…”

Section: Obesitysupporting

confidence: 79%

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Gaillard

Durmuş

Hofman

et al. 2013

Obesity

418

359

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Objective: The prevalence of overweight and obesity among women of reproductive age is increasing. We aimed to determine risk factors and maternal, fetal and childhood consequences of maternal obesity and excessive gestational weight gain. Design and Methods: The study was embedded in a population-based prospective cohort study among 6959 mothers and their children. The study was based in Rotterdam, The Netherlands (2001-2005. Results: Maternal lower educational level, lower household income, multiparity, and FTO risk allel were associated with an increased risk of maternal obesity, whereas maternal European ethnicity, nulliparity, higher total energy intake, and smoking during pregnancy were associated with an increased risk of excessive gestational weight gain (all p-values <0.05). As compared to normal weight, maternal obesity was associated with increased risks of gestational hypertension (OR 6.31 (95% CI 4.30, 9.26)), preeclampsia (OR (3.61, (95% CI 2.04, 6.39)), gestational diabetes (OR 6.28 (95%CI 3.01, 13.06)), caesarean delivery (OR 1.91 (95% CI 1.46, 2.50)), delivering large size for gestational age infants (OR 2.97 (95% CI 2.16, 4.08)), and childhood obesity (OR 5.02 (95% CI:2.97, 8.45)). Weaker associations of excessive gestational weight gain with maternal, fetal and childhood outcomes were observed, with the strongest effects for first trimester weight gain. Conclusions: Our study shows that maternal obesity and excessive weight gain during pregnancy are associated with socio-demographic, lifestyle, and genetic factors and with increased risks of adverse maternal, fetal and childhood outcomes. As compared to prepregnancy overweight and obesity, excessive gestational weight gain has a limited influence on adverse pregnancy outcomes.

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Section: Obesitysupporting

confidence: 79%

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Gaillard

Durmuş

Hofman

et al. 2013

Obesity

418

359

View full text Add to dashboard Cite

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“…The dose-dependent relationship between an increasing maternal BMI and a higher risk for cesarean delivery remains even after adjusting for obesityassociated co-morbidities (11,54). The risk appears to be confined to the active phase of labor (54) and is mainly a result of a failure to progress /dysfunctional labor (55)(56)(57).…”

Section: Onset and Progression Of Labor In Obese Womenmentioning

confidence: 90%

“…Post-dated pregnancies, induction of labor (IOL) and abnormal labor progression are more common in obese women. The rates of both elective and emergency CS successively increase with maternal BMI (11)(12)(13). Postoperative complications, including postpartum hemorrhage, anesthesiology complications, infections and thromboembolic complications, are also more common in obese women (9,14).…”

Section: Maternal Complications Associated With Obesitymentioning

confidence: 99%

Maternal obesity, duration of labor and the role of leptin

Carlhäll¹

2018

Linköping University Medical Dissertations

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Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process.

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“…(Poobalan i sur.) povišeni ITM prije trudnoće predstavljao je nezavisni rizični faktor i za elektivni i za hitni carski rez 25 . Gunatilake i sur.…”

Section: Operativno Dovršenje Trudnoćeunclassified

Pre-pregnancy body mass index and perinatal outcome

Barišić

Finderle

2017

Med. flum.

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Sažetak. Cilj: Utvrditi odnos indeksa tjelesne mase prije trudnoće i perinatalnog ishoda trudnica zaprimljenih na Kliniku za ginekologiju i porodništvo Kliničkog bolničkog centra (KBC) Rijeka u razdoblju od 1. siječnja 2010. do 31. prosinca 2014. godine. Ispitanici i metode: Analizirana je skupina od 14 779 trudnica na temelju podataka prikupljenih iz baze podataka Klinike za ginekologiju i porodništvo KBC-a Rijeka. Rezultati: Trudnice s indeksom tjelesne mase (ITM) < 18 imaju statistički značajno veće izglede u odnosu na trudnice s ITM-om 18 -24,99 za: intrauterino zaostajanje djeteta u razvoju (P < 0,001), rađanje prematurusa (P = 0,005), prijeteći pobačaj (P = 0,001), rađanje djeteta < 2 500 g (P = 0,022) te fetalnu smrt (P = 0,019). Trudnice s ITM-om 25 -29,99 imaju veće izglede u odnosu na trudnice s ITM-om 18 -24,99 za: gestacijski dijabetes melitus (P < 0,001), gestacijsku hipertenziju (P < 0,001), preeklampsiju (P = 0,007), acidozu djeteta u porodu (P = 0,029), rađanje djeteta s Apgar indeksom ≤ 7 (P = 0,001) te djeteta porodne težine < 2 500 g (P < 0,001) i ≥ 4 000 g (P < 0,001). Također, povećan je izgled za fetalnu smrt (P = 0,001), instrumentalni vaginalni porod (P = 0,041) te dovršenje poroda hitnim carskim rezom (P < 0,001). Trudnice s ITM-om ≥ 30 imaju veće izglede u odnosu na trudnice s ITM-om 18 -24,99 za: gestacijski dijabetes melitus (P < 0,001), gestacijsku hipertenziju (P < 0,001), preeklampsiju (P < 0,001), rađanje prematurusa (P = 0,001), djeteta s Apgar indeksom ≤7 (P = 0,001) te djeteta porodne težine < 2 500 g (P < 0,001) i ≥ 4 000 g (P < 0,001). Povećan je izgled za febrilitet majki u puerperiju (P = 0,001), dojenačku smrt (P = 0,001) te dovršenje poroda hitnim (P < 0,001) i elektivnim carskim rezom (P = 0,001). Zaključak: Ovom retrospektivnom analizom pokazano je kako su trudnice s ITM-om < 18 (pothranjene) i one s ITM-om > 25 (preuhranjene i pretile) u povećanom riziku za razvoj perinatalnih komplikacija.Ključne riječi: indeks tjelesne mase; perinatalne komplikacije; pothranjenost; pretilost; preuhranjenost Abstract. Aim: To determine the connection of maternal body mass index (BMI) before pregnancy with perinatal outcome of pregnant women received at the Department of Obstetrics and Gynecology, Clinical Hospital Center Rijeka, during the period from 1 January 2010 to 31 December 2014. Patients and methods: We analyzed a group of 14,779 pregnant women, based on data collected from the Register of Clinical Hospital Center Rijeka. Results: Women with a BMI < 18 are more likely in the diagnosis of intrauterine growth restriction (P < 0.001), premature birth (P = 0.005) and threatened abortion (P = 0.001), giving birth of a child < 2500 g (P = 0.022), fetal death (P = 0.019). Pregnant women with a BMI 25-29.99 are more likely to: gestational diabetes mellitus (P < 0.001), gestational hypertension (P < 0.001), preeclampsia (P = 0.007), child acidosis at birth (P = 0.029), Apgar index ≤ 7 (P = 0.001), birth weight < 2500 g (P < 0.001) and ≥ 4000 g (P < 0.001). They are also in statisticall...

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Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta‐analysis of cohort studies

Cited by 338 publications

References 22 publications

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Maternal obesity, duration of labor and the role of leptin

Pre-pregnancy body mass index and perinatal outcome

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