The impact of maternal obesity and weight gain on vaginal birth after cesarean section success

Durnwald, Celeste; Ehrenberg, Hugh M.; Mercer, Brian M.

doi:10.1016/j.ajog.2004.05.051

Cited by 121 publications

(72 citation statements)

References 16 publications

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“…This agrees with previous reports on underweight mothers. [7][8][9][10] Concerning obese women, these data support the need to consider additional categories. The risk for caesarean delivery changes within the different states of obesity: between obese (30-34.9 kg/m 2 ), very obese (35-39.9) and extremely obese (40-44.9).…”

Section: Maternal Height (Centimeters)mentioning

confidence: 69%

“…or to look at other risk factors like weight gains during pregnancies. 10,13 These data highlight the importance of considering both the distal ends of the BMI distribution. Although caution is warranted for the small sample sizes, very lean women (10-14.9 kg/m 2 , n = 54, Table 3) were more likely to deliver vaginally than lean women (15-19.9) and more likely than women with normal BMI.…”

Section: Maternal Height (Centimeters)mentioning

confidence: 99%

“…13 Further, for Durnwald et al, 10 among women with a history of caesarean section, those having a normal BMI at the first pregnancy but an overweight at the second one presented a decreased rate of vaginal delivery as compared with those who kept a stable BMI between the two pregnancies. Maternal and fetal factors may add to result in this linear shape of caesarean section risk.…”

Section: Maternal Height (Centimeters)mentioning

confidence: 99%

“…[1][2][3][4][5][6][7] It has also been reported by some authors that maternal underweight has a protective effect. [8][9][10] Others have emphasised the role of short stature (<1.55 m) as a high-risk factor. 11 Although caesarean delivery is not uncommon (17% of all live births in our maternity and 15.4% in term singleton pregnancies), it does represent major surgery with documented risks.…”

Section: Introductionmentioning

confidence: 99%

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Linear association between maternal pre‐pregnancy body mass index and risk of caesarean section in term deliveries

Barau

et al. 2006

BJOG

134

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Objective Maternal obesity is a well-known risk factor for caesarean delivery. The aim of this study is to determine whether all the spectrum of pre-pregnancy maternal corpulence (body mass index [BMI]) is associated with the risk of caesarean delivery.Design Observational study over 4.5 years .Setting Groupe Hospitalier Sud-Réunion's maternity (island of La Réunion, French overseas department, Indian Ocean).Population All consecutive singleton live births having delivered at the maternity.Methods Data have been analysed according to different risk factors. Maternal corpulence has been defined as the maternal pre-pregnancy weight. BMIs have been studied by multiples of 5 kg/m 2 from 10-14.9 kg/m 2 to 40-44.9 kg/m 2 .Main outcome measure Rate of caesarean section.Results There were 17 462 singleton live births during the period, of which 16 952 (97.1% of the total) pre-pregnancy BMIs have been determined. There is a linear association (x 2 for linear trend, P < 0.001) between maternal corpulence and risk of caesarean deliveries, the leanest mothers having the best rate of vaginal delivery. This linear association exists in a model controlling for diagnosis of gestational diabetes, term deliveries ( ‡37 weeks), very short maternal height (<1.50 m), primiparity and maternal age ‡ 35 years (adjusted x 2 , P < 0.001).Conclusion There is a significant linear association between prepregnancy maternal corpulence and risk of caesarean deliveries in pregnancies at term. The authors discuss several interpretations including the adaptability of fetal birthweights to maternal corpulence and the concept of soft-tissue dystocia.

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Section: Maternal Height (Centimeters)mentioning

confidence: 69%

Section: Maternal Height (Centimeters)mentioning

confidence: 99%

Section: Maternal Height (Centimeters)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Linear association between maternal pre‐pregnancy body mass index and risk of caesarean section in term deliveries

Barau

et al. 2006

BJOG

134

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“…Most previous studies of the association between body mass and the risk of caesarean delivery have examined groups of women at risk only for intrapartum caesarean delivery 2,10,[18][19][20][21] or have used caesarean delivery as an outcome measure without distinguishing between elective and intrapartum procedures. 1,3,8,[11][12][13]22,23 Four studies that did examine the effect of body mass index (BMI) on caesarean delivery risk before and after labour did not attempt to disentangle the influence of body mass from the known effects of birthweight, diabetes, and hypertension.…”

Section: Introductionmentioning

confidence: 99%

Maternal anthropometric risk factors for caesarean delivery before or after onset of labour

Sherrard¹,

Platt

Vallerand³

et al. 2007

BJOG

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Objective To quantify the effects of pre-pregnancy body mass and gestational weight gain, above and beyond their known effects on birthweight, on the risk of primary and repeat caesarean delivery performed before or after the onset of labour.Design Hospital-based historical cohort study.Setting Canadian university-affiliated hospital.Population A total of 63 390 singleton term ( ‡37 weeks gestation) infants with cephalic presentation.Methods We studied prospectively archived deliveries at the Royal Victoria Hospital in Montreal, Canada, from 1 January 1978 to 31 March 2001 using multiple logistic regression models to estimate relative odds of caesarean delivery.Main outcome measure Caesarean delivery, primary or repeat and before or after the onset of labour.Results Pregravid obesity (body mass index ‡30 kg/m 2 ) increased the likelihood of primary caesarean delivery before (OR = 2.01, 95% CI 1.39-2.90) and after (OR = 2.12, 95% CI 1.86-2.42) the onset of labour. High net rate of gestational weight gain (>0.50 kg/week) increased the risk but only after labour onset (OR = 1.40, 95% CI 1.23-1.60). Among women with a previous caesarean, high weight gain modestly increased risk but only before labour (OR = 1.38, 95% CI 1.04-1.83), whereas obesity increased the risk of caesarean delivery both before (OR = 1.85, 95% CI 1.44-2.37) and after (OR = 1.96, 95% CI 1.11-3.47) labour onset. Increased risks of macrosomia accounted for the association between pregravid adiposity and repeat caesarean delivery performed after but not before the onset of labour.Conclusions Pregravid obesity increases the risk of caesarean delivery both before and after the onset of labour and both with and without a history of caesarean.

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Special Concerns for the Obese Patient

Ehrenberg¹,

Wissler²

2010

De Swiet's Medical Disorders in Obstetric Practice

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The impact of maternal obesity and weight gain on vaginal birth after cesarean section success

Cited by 121 publications

References 16 publications

Linear association between maternal pre‐pregnancy body mass index and risk of caesarean section in term deliveries

Linear association between maternal pre‐pregnancy body mass index and risk of caesarean section in term deliveries

Maternal anthropometric risk factors for caesarean delivery before or after onset of labour

Special Concerns for the Obese Patient

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