Body mass index‐related cesarean section complications in sub‐Saharan Africa: A systematic review and meta‐analysis

Abstract

Background: Obesity and cesarean section (CS) rates are rising in sub-Saharan Africa (SSA), where risks for complications that adversely affect maternal health, such as infections, are high.Objective: To conduct a systematic review and meta-analysis to report on the incidence and types of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters)-related complications following CS in SSA.Search strategy: A systematic search was conducted in PubMed/MEDLINE, EMBASE, and Global Health Library up to August 2020 using (MeSH) terms related to CS, BMI, and SSA.Selection criteria: Quantitative studies that evaluated BMI-related complications of CS in English.Data collection and analysis: Data were extracted using a standardized form. The risk of bias was assessed using the Newcastle-Ottawa Scale. The incidence of BMIrelated complications at 95% confidence interval was calculated and a meta-analysis conducted.Main results: Of 84 articles screened, five were included. Complications associated with a higher BMI were: wound infection, hemorrhage, post-dural puncture headache, and prolonged surgery time in comparison with patients with a normal BMI. Women with a high BMI (>25.0) have a two-fold increased risk for post-cesarean wound infection compared with women with a normal BMI (20.0-24.9) (odds ratio 1.91, 95% confidence interval 1.11-3.52). Conclusion:Overweight and obesity were associated with CS complications in SSA, but limited research is available.

Association of overweight and obesity with cumulative live birth rates according to women's age: A cohort study of 26 567 treatment cycles

“…1 Overweight and obesity are linked to a multitude of negative effects on natural conception and assisted reproductive technology (ART) outcomes, including higher rates of infertility, decreased live birth rates, greater risks of miscarriage, and obstetric complications. [3][4][5][6][7] Although weight loss is often recommended as the first step for obese women seeking treatment for infertility, the effects of reducing weight and the understanding of weight-related fertility decline remain unclear. [8][9][10][11]…”