Effect of overweight/obesity on caesarean section occurrence among reproductive-aged women in Ethiopia: a secondary data analysis

Abstract

BackgroundThe burden of overweight/obesity increased worldwide and it has unpredictable effect on maternal morbidity and mortality. Different adverse perinatal outcomes observed in overweight/obese women, of those caesarean section occurred frequently. In Ethiopia, the national caesarean section and overweight/obesity rate among reproductive-aged women increased tremendously. Therefore, we intend to assess the association between overweight/obesity with caesarean section in Ethiopia.MethodThe data were extracted from the 2016 Ethiopia Demographic and Health Survey in nine regions and two city administrations. A stratified two-stage random sampling design was used to collect data. The exposure variable was overweight/obesity, and the outcome variable was a caesarean section. The final analytical sample consisted of 6928 participants. SPSS V.23 was used to analyse the data. Descriptive statistics and cross-tabulation were performed to describe the study variables. Univariable and multivariable logistic regression models were regressed.ResultsThe prevalence of caesarean section among women aged between 15–49 years old who gave birth in the last 5 years was 245 (3.54%). The occurrence of caesarean section among overweight/obese women was 2.05 higher as compared with normal-weight women (AOR: 2.05, 95% CI: 1.09 - 3.83).Conclusion and recommendationPromoting weight reduction programmes throughout the country would have a greater contribution to reduce caesarean section rate and health cost, and to improve the health of the mother.

Prevalence and associated factors of caesarian section in Ethiopia: a multilevel analysis of the 2019 Ethiopia Mini Demographic Health Survey

“…The prevalence of caesarian section in Bahirdar, Northern Ethiopia was 41.8%, and factors like delivery in private health facilities, breech presentation, urban residence, being referred, being government employees, and parity associated with the increased magnitude [ 26 ]. The caesarian section was also performed more among obese women as revealed by one study [ 27 ]. In Addis Ababa, the prevalence of caesarian section was 38.3%, while having some risk factors like delivering in private health facility and maternal education were associated in the rural areas [ 28 ].…”

Maternal Obesity as a Risk Factor for Caesarean Delivery in Sub-Saharan Africa: A Systematic Review

“…All the included studies were observational studies except for Davies et al, [47] which was a sub-study of a randomised controlled trial (Table 3). Three of the studies used a case-control design [39,40,45], six studies used a cross-sectional design [38,44,46,50,52,53], and seven studies used a cohort design [10,[41][42][43]48,49,51].…”

“…Most of the studies were conducted in Nigeria (6/17) [39][40][41][42][43][44]; and South Africa (3/17) [45][46][47] (Table 3). Twelve of the included studies were conducted either in tertiary health centres or maternity clinics [10,[39][40][41][42][43]45,46,[48][49][50][51]; while the other 5 studies were conducted in community or neighbourhood settings [38,44,47,52,53].…”

“…Two other studies measured maternal BMI at ≤25 weeks [42] and ≤32 weeks [39]. Four cross-sectional studies accepted BMI measurements from participants who delivered up to 5 years before the study was conducted [38,44,52,53]. Only one retrospective study compared caesarean delivery outcomes in participants with maternal BMI recorded before pregnancy [49].…”

“…Most studies used a BMI ≥ 30 kg/m 2 as the cut-off for obesity except for Davies et al, [47], which used a BMI ≥ 29 kg/m 2 . Three studies combined overweight and obese participants and compared them to normal or optimal weight individuals (BMI = 18.5-24.9 2 ) [50][51][52]; while four other studies compared participants in different categories of obesity to those with normal/optimal weight [10,38,42,46].…”