Maternal obesity and risk of cesarean delivery: a meta‐analysis

Abstract

Despite numerous studies reporting an increased risk of cesarean delivery among overweight or obese compared with normal weight women, the magnitude of the association remains uncertain. Therefore, we conducted a meta-analysis of the current literature to provide a quantitative estimate of this association. We identified studies from three sources: (i) a PubMed search of relevant articles published between January 1980 and September 2005; (ii) reference lists of publications selected from the search; and (iii) reference lists of review articles published between 2000 and 2005. We included cohort designed studies that reported obesity measures reflecting pregnancy body mass, had a normal weight comparison group, and presented data allowing a quantitative measurement of risk. We used a Bayesian random effects model to perform the meta-analysis and meta-regression. Thirty-three studies were included. The unadjusted odd ratios of a cesarean delivery were 1.46 [95% confidence interval (CI): 1.34-1.60], 2.05 (95% CI: 1.86-2.27) and 2.89 (95% CI: 2.28-3.79) among overweight, obese and severely obese women, respectively, compared with normal weight pregnant women. The meta-regression found no evidence that these estimates were affected by selected study characteristics. Our findings provide a quantitative estimate of the risk of cesarean delivery associated with high maternal body mass.

Maternal body mass index and congenital anomaly risk: a cohort study

“…Health implications for the mother include increased risk of insulin resistance and gestational diabetes, hypertensive disorders, and increased caesarean section rates. [4][5][6] For the infant, the health implications of maternal obesity include increased birthweight, stillbirth and neonatal death, and shoulder dystocia during delivery. [7][8][9] (see Box 1 for definitions of obstetric terminology).…”

Childhood Health and Developmental Outcomes After Cesarean Birth in an Australian Cohort

“…Women who are overweight and obese during pregnancy are more likely to undergo cesarean delivery, 30 and maternal overweight and obesity are among the strongest risk factors for childhood obesity. 31,32 The 2 positive effects associated with cesarean delivery were unexpected. The prosocial subscale of the Strengths and Difficulties Questionnaire examines children's positive functioning rather than behavioral problems; it seeks parental responses to whether children readily share (eg, treats, toys, pencils) with other children; whether they are helpful if someone is hurt or upset; are kind to other children; or volunteer to help parents or teachers.…”

Differential attentional responding in caesarean versus vaginally delivered infants

“…Some of the other factors that might distinguish infants born by caesarean section from those born vaginally include, but are not limited to, maternal weight (Chu et al, 2007;Galtier-Dereure, Montpeyroux, Boulot, Bringer, & Jaffiol, 1995), fetal status and weight (Barber et al, 2011), and position of the fetus in the uterus (Akmal, Kametas, Tsoi, Howard, & Nicolaides, 2004). Each of these factors has been associated with an increased probability of caesarean-section delivery, and consequently, each factor might contribute to the attentional deficit of caesarean-section delivery revealed in the present study.…”