Objective: Obesity is a pervasive public health problem among women in United States and is associated with significant excess of morbidity and morality. The objective of this study was to determine if women with obesity at delivery are more likely to deliver by cesarean section compared to nonobese women. Study Methods: A search of all records of singleton deliveries of women who delivered only once a t Mount Sinai Hospital between January 1"' 1987 and December 31"' 1997 was done from the perinatal computerized database. The body mass index (BMI) at delivery (weight in kilograms divided by the square of height in meters) was calculated for each record. Records with: a) missing or inappropriate height and/or weight, b)BMI<12kg/mZ, c) age<11 and > 47 years old, and d) birth weight ~500 grams, were excluded. Obesity was defined as BMIr30 kg/m2 at delivery. The relative risk of cesarean section of obese women compared to non-obese was calculated. Results: Total 20,372 records met the inclusion and exclusion criteria. Only 291 records (1.4%) were previously excluded. Forty percent of women (8,213) were obese at delivery and 60% were not (12,159). The cesarean section rate for the obese group was 16.9% (1391) compared to 9.6% (1178) for the non-obese group. The relative risk of cesarean section for obese women is 1.75 (95% confidence interval 1.63-1.88; P<0.00000001) compared to non-obese women. Conclusions: Obese women at delivery have almost twice the risk of delivering a singleton by cesarean section than non-obese women.
P3.03.13 RISK FACTORS FOR CESAREAN SECTION
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