Obesity, obstetric complications and cesarean delivery rate–a population-based screening study

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

“…24 Trends from the published literature consistently show higher caesarean section rates with increasing BMI. 13,18,25,26 In our population of glucose tolerant women, the aOR for elective caesarean section was 1.7 in overweight mothers and 4.4 in women with grade III obesity when compared to mothers with normal BMI. A similar trend was seen for emergency caesarean section, the aOR rising from 1.4 to 3.5 across the range of BMI categories from overweight to grade III obesity.…”

“…8,13 In those proceeding to delivery by caesarean section, obesity carries a risk of failed regional anaesthesia, inadequate analgesia, difficulty with intravenous access and requirement for general anaesthetia, which is in turn complicated by obesity-related difficulty with intubation. 25,27 Operative wounds following caesarean sections are also more likely to get infected and break down, leading to specific recommendations for subcutaneous suturing and antibiotic prophylaxis. Puerperal infections of the respiratory and urinary tract are also more likely with raised BMI.…”

“…Puerperal infections of the respiratory and urinary tract are also more likely with raised BMI. 25 There is also compelling evidence demonstrating increased risk of antepartum and postpartum haemorrhage in obese mothers, which can be reduced with active management of the third stage of labour. 26 A particularly worrying report describes maternal obesity as the greatest risk factor for maternal mortality in the developed world, the recent United Kingdom Confidential Enquiry into Maternal And Child Health (CEMACH) show 50% of maternal deaths occurring in obese women and 15% in women classified as grade III obesity.…”

Prepregnancy Obesity and Birth Outcomes

“…They are also more likely to give birth by c-section (12)(13)(14)(15)(16). Obese women are at greater risk for medically induced preterm birth (2,17) and women who are obese prepregnancy are less likely to initiate breastfeeding and breastfeed for shorter durations (18).…”

Implications of the Revised Consensus Body Mass Indices for Asian Indians on Clinical Obstetric Practice

“…Obesity in pregnant women is associated with adverse perinatal events including an increased risk of gestational diabetes, preeclampsia, infection, and operative deliveries including caesarean sections, wound infection and endometritis and offspring at increased risk for birth defects, macrosomia, and morbidity associated with subsequent childhood obesity [9][10][11][12][13][14][15][16][17][18]. The aims of this single centre retrospective study was to firstly assess the impact of the revised guidelines on the prevalence of obesity and overweight in pregnant women and secondly to examine the direction and magnitude of pregnancy outcomes associated with obesity and overweight in this population.…”