Use of the Robson classification to understand the increased risk of cesarean section in case of maternal obesity.

Créquit, Simon; Korb, Diane; Morin, Cécile; Schmitz, Thomas; Sibony, Olivier

doi:10.21203/rs.3.rs-56784/v1

Cited by 3 publications

(5 citation statements)

References 10 publications

(11 reference statements)

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“…Therein, women in Robson Groups 2 and 5 were the largest contributors to the overall CS rate among all age groups; prior CS, nulliparity and use of IT were associated with a higher risk of CS 27 . A recent French study reported a higher rate of CS in women with (28.1%) than without (14.2%) obesity, largely explained by those in Robson Group 5 28 . In the current study, we took into account similar factors, suggesting that maternal age, obesity, comorbidities and certain obstetrical complications do not completely explain the higher rate of CS observed in women with infertility.…”

Section: Discussionmentioning

confidence: 94%

“…27 A recent French study reported a higher rate of CS in women with (28.1%) than without (14.2%) obesity, largely explained by those in Robson Group 5. 28 In the current study, we took into account similar factors, suggesting that maternal age, obesity, comorbidities and certain obstetrical complications do not completely explain the higher rate of CS observed in women with infertility. Herein, multiple pregnancy contributed the most to the observed high rate of CS in women with non-invasive or invasive IT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Caesarean birth in women with infertility: population‐based cohort study

Richmond

Ray

Pudwell

et al. 2021

BJOG

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Objective Caesarean section (CS) is more common following infertility treatment (IT) but the reasons why remain unclear and confounded. The Robson 10-Group Classification System (TGCS) may further explain variation in CS rates. We assessed the association between mode of conception and CS across Robson groups.Design Population-based cohort study.Setting Ontario, Canada, in a public healthcare system.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Caesarean birth in women with infertility: population‐based cohort study

Richmond

Ray

Pudwell

et al. 2021

BJOG

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show abstract

“…Thus, effective interventions aimed to prevent and reduce overweight and obesity during the pre-pregnancy period is required. This is critical as maternal obesity can have adverse effects not only for the health of pregnant women but also for the health status of their progeny [22,23] . A Cesarean section is a medical intervention that can have serious medical complication for the pregnant women, the newborn and increases the cost burden for the health system.…”

Section: Discussionmentioning

confidence: 99%

Association between the pre-pregnancy body mass index and risk of cesarean section: A case-control study

Gutarra-Vilchez¹,

Gutarra-Samn²,

Campos-Solrzano³

et al. 2021

Int. J. Clin. Obstet. Gynaecol.

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To estimate the association between the pre-pregnancy Body Mass Index (BMI) and the weight categories with the risk of cesarean section in Peruvian women. Methods: A Case-control study was conducted. The present study included 13 734 pregnant women (cases=4578 and controls=9156). The pre-pregnancy BMI and overweight and obesity status were the main risk factors. Logistic regression was used to assess the association between the main exposures and cesarean section. Results: Higher BMI values were associated with cesarean delivery (adjusted Odds Ratio (aOR): 1.081, 95% CI 1.067-1.095, P<0.001). When bodyweight status was considered, women with overweight (aOR: 1.461, 95% IC 1.172-1.823, P: 0.001) and obesity (OR: 1.810, 95% IC 1.578-2.076, P<0.001) during the pre-pregnancy had a higher likelihood of cesarean section compared to those with normal weight. Conclusion: Pre-pregnancy higher BMI values, particularly those of overweight and obesity status were independent risks for cesarean delivery in Peruvian women.

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“…First, the alarmingly high prevalence of obesity among women in our study population, coupled with the significant link between obesity and CS, highlights the importance of obesity prevention and treatment as part of maternal healthcare in Suriname [31]. Additionally, implementing strategies to prevent CS among this group is crucial to enhance maternal and perinatal health outcomes, particularly given the elevated risk of CS complications among obese women [31][32][33]. Challenges in reducing CS in this group include adequate foetal monitoring and the different labor progression than those with a normal weight, often requiring longer cervical ripening and dilation, as well as potentially needing higher doses of oxytocin [32,34,35].…”

Section: Adverse Neonatal Outcomesmentioning

confidence: 95%

“…Maternal age was categorized into teenage pregnancy (<20 years) and advanced maternal age (> 36 years) [22,23]. Body Mass Index (BMI) was categorized according to the WHO classification as pre-obesity (BMI 25-30), obesity class I and II (BMI [30][31][32][33][34][35][36][37][38][39][40], and obesity class III (BMI >40) [24]. Ethnicity was self-reported by women.…”

Section: Variables and Definitionsmentioning

confidence: 99%

Cesarean sections in Suriname using Robson classification: a two-year nationwide cross-sectional study

Prüst,

Dupont,

Liesdek

et al. 2024

Preprint

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Background – Cesarean Section (CS) rates are increasing concerningly. Optimizing CS performance is a global health priority, given the maternal and perinatal morbidity and mortality associated with both underuse and overuse. This nationwide study in Suriname aims to (1) determine the national, facility-based CS rate and explore which women are at highest risk and (2) use the WHO Robson classification to enhance understanding drivers and outcomes of CS to develop tailored interventions. Methods – An observational, cross-sectional study in Suriname, using nationwide birth registry data that included all hospital births in 2020 and 2021. We used multivariate logistic regression analysis to assess maternal and perinatal characteristics associated with CS. We described caesarean births according to the Robson-10 classification and used descriptive statistics to analyze CS frequencies and neonatal outcomes. Results – We analyzed the 18,917 women who gave birth in Surinamese hospitals, with an overall 23.9% CS rate (n=4522). The highest CS rates were seen among women with a previous CS(69.3%, aOR 16.2, 95% CI 14.4 – 18.2), BMI > 40 (47.0%, aOR 5.1, 95% CI 4.0 – 6.5), newborn with a birth weight above 4000 grams (37.3%, 2.2, 95% CI 1.6 – 3.0) and women giving birth at hospital IV (38.5%, aOR 1.8, 95% CI 1.6 – 2.0). Hindustani women were more likely to give birth by CS compared to maroon women (aOR 1.6, 95% CI 1.4 – 2.0). Robson group 5 (i.e. multiparous, term women with a previous CS and cephalic presentation), contributed to 30.5% of the CS cases (n=1378). Robson group 2 and 4 (i.e. pre-labor CS, or CS after induction, among term women without previous CS and cephalic presentation) contributed to 21.8% (n=985) of all CS performed. Robson group 1 and 3 (i.e. during spontaneous labor CS among term women without previous CS and cephalic presentation) accounted for 23.3% (n=1052) of the CS cases. Conclusion – The CS rate in Suriname is 24%, with substantial intra-country and inter-hospital variations. These disparities underscore the need for targeted interventions addressing both overuse and underuse of CS. Preventative measures should prioritize promoting safe VBAC, preventing first-time CS and ongoing monitoring of trends and regular case audits.

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Use of the Robson classification to understand the increased risk of cesarean section in case of maternal obesity.

Cited by 3 publications

References 10 publications

Caesarean birth in women with infertility: population‐based cohort study

Caesarean birth in women with infertility: population‐based cohort study

Association between the pre-pregnancy body mass index and risk of cesarean section: A case-control study

Cesarean sections in Suriname using Robson classification: a two-year nationwide cross-sectional study

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