Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study

Abstract

Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.

Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy

“… 3 , 25 In many studies, maternal overweight and obesity were significantly associated with a higher risk of cesarean delivery, particularly in low- and middle-income countries. 3 , 20 , 28 , 29 In high-income countries (eg, Europe, Central Asia, and South Asia), a BMI ≥ 25 kg/m 2 was associated with an emergency cesarean section. 29 Similarly, in our model, maternal BMI < 25 kg/m 2 at delivery significantly increased the probability of vaginal birth.…”

“… 3 , 20 , 28 , 29 In high-income countries (eg, Europe, Central Asia, and South Asia), a BMI ≥ 25 kg/m 2 was associated with an emergency cesarean section. 29 Similarly, in our model, maternal BMI < 25 kg/m 2 at delivery significantly increased the probability of vaginal birth. Additionally, the pattern of overweight and obesity differs between ethnicities, countries, regions, and the level of income.…”

Cesarean birth rates among migrants in Europe: A systematic review

“…One additional paper was identified for full‐text assessment through searching reference lists of included studies, resulting in full‐text assessment being carried out on 54 papers in total. Twenty‐one papers were included in the final review and analysis 28–48 . Figure 1 illustrates the selection process, the number of studies identified and excluded at each stage, and the reasons for exclusion, in line with the PRISMA 2020 statement 49 .…”

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

“…There is strong evidence which suggests that maternal pre-pregnancy overweight and obesity increases the probability of caesarean delivery [14,34,35]. Moreover, overweight, and obese women who had a caesarean section experienced more adverse outcomes when compared to normal weight women with a caesarean section or obese women with a vaginal delivery [36].…”