The combined effect of pre-pregnancy body mass index and gestational weight gain on the risk of pre-labour and intrapartum caesarean section—The ICE-MCH study

Abstract

Women who are obese before pregnancy have a higher risk of caesarean section than normal weight women. We investigated the combined effect of pre-pregnancy weight and gestational weight gain on pre-labour and intrapartum caesarean section risk. We collected data on 22,763 singleton, term, live deliveries in 2003–2014 from the Icelandic Maternal and Child Health Study (ICE-MCH), based on Icelandic registries. These were the Icelandic Medical Birth Registry and the Saga Maternal and Child Health Database. Pre-pregnancy body mass index was categorised into underweight, normal weight, overweight and obese. Gestational weight gain was classified according to the Institute of Medicine´s recommendation into below, within and above the recommended range. Logistic regression models, adjusted for maternal and gestational characteristics, were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI) for the risk of caesarean section. Obese women had a higher risk of pre-labour (AOR 1.56, 95% CI 1.34–1.81) and intrapartum caesarean section (AOR 1.92, 95% CI 1.70–2.17) than normal weight women in all categories of gestational weight gain. Gestational weight gain above the recommended range, compared to within the range, increased the risk of intrapartum caesarean section among normal weight (AOR 1.46, 95% CI 1.23–1.73) and overweight women (AOR 1.291, 95% CI 1.04–1.60). Gestational weight gain below the recommended range, compared to within the range, increased the risk of pre-labour caesarean section (AOR 1.64, 95% CI 1.20–2.25), but only among overweight women. Women who are obese before pregnancy have a high risk of caesarean section regardless of gestational weight gain. However, women who are normal weight or overweight before pregnancy and gain weight above the recommended range during pregnancy may also have an increased risk of caesarean section.

Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy

“…Maternal and child health are crucial determinants of a nation’s overall health and development. The impact of weight gain during pregnancy on short-term and long-term health outcomes underscores its significance in comprehensive pregnancy health management [ 1 , 2 , 3 , 4 ]. The findings, based on existing research evidence, suggested that excessive gestational weight gain (GWG) could lead to cesarean section, maternal weight retention, large-for-gestational-age (LGA) infants, gestational hypertension, preeclampsia, and gestational diabetes mellitus (GDM).…”

Evaluation of the Predictors of Successful Vaginal Delivery in Women After Previous Caesarean Section, a Prospective Study in a Tertiary Care Hospital

“…Several researchers have attempted to determine the factors that are linked to a successful Vaginal Birth after Caesarean (VBAC). These factors include: having had a previous vaginal birth before a caesarean section (CS), having had a previous successful VBAC, having a normal body mass index before pregnancy, having a higher bishop score and a favourable cervical status upon admission, being of a younger maternal age, and having a non-recurring indication for a previous CS such as fetal malpresentation and a non-reassuring fetal heart pattern (34-38) (Eloranta et al, 2023;Girma et al, 2021;Li et al, 2019;Tesfahun et al, 2023). Presently, apprehensions regarding the potential hazards of TOLAC have resulted in only a handful of obstetricians and expectant mothers who are prepared to undergo TOLAC voluntarily.…”

Effect of the smartphone application on caesarean section in women with overweight and obesity: a randomized controlled trial in China

“…In addition to pre-pregnant overweight and obesity, gestational weight gain (GWG) above the recommendation of Institute of Medicine (IOM, 7.0-11.5 kg for overweight and 5.0-9.0 kg for obesity) can also increase the risk of CS. Eloranta AM et al found that excessive GWG increased the risk of intrapartum caesarean section among normal weight (adjusted odds ratio [aOR] 1.46, 95%CI 1.23–1.73) and overweight women (aOR 1.291, 95%CI 1.04–1.60) [ 9 ]. In the Chinese population, the aOR of CS was 1.42 (95% CI 1.06–1.88) for excessive GWG [ 10 ].…”