The maternal body mass index: a strong association with delivery route

• Published in: American journal of obstetrics and gynecology Vol. 203; no. 3; pp. 264.e1 - 264.e7
• Main Authors: Kominiarek, Michelle A., MD, VanVeldhuisen, Paul, PhD, Hibbard, Judith, MD, Landy, Helain, MD, Haberman, Shoshana, MD, Learman, Lee, MD, PhD, Wilkins, Isabelle, MD, Bailit, Jennifer, MD, Branch, Ware, MD, Burkman, Ronald, MD, Gonzalez-Quintero, Victor Hugo, MD, Gregory, Kimberly, MD, Hatjis, Christos, MD, Hoffman, Matthew, MD, Ramirez, Mildred, MD, Reddy, Uma M., MD, Troendle, James, PhD, Zhang, Jun, MD, PhD
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Body Mass Index; cesarean delivery; Cesarean Section - statistics & numerical data; Cohort Studies; Delivery. Postpartum. Lactation; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; obesity; Obstetrics and Gynecology; Parity; Pregnancy; Recurrence; Regression Analysis; Risk Assessment; body mass index; obesity; cesarean delivery; Body mass index; Delivery; Mother; Obstetrics; Gynecology
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.06.024

Objective We sought to assess body mass index (BMI) effect on cesarean risk during labor. Study Design The Consortium on Safe Labor collected electronic data from 228,668 deliveries. Women with singletons ≥37 weeks and known BMI at labor admission were analyzed in this cohort study. Regression analysis generated relative risks for cesarean stratifying for parity and prior cesarean while controlling for covariates. Results Of the 124,389 women, 14.0% had cesareans. Cesareans increased with increasing BMI for nulliparas and multiparas with and without a prior cesarean. Repeat cesareans were performed in >50% of laboring women with a BMI >40 kg/m2 . The risk for cesarean increased as BMI increased for all subgroups, P < .001. The risk for cesarean increased by 5%, 2%, and 5% for nulliparas and multiparas with and without a prior cesarean, respectively, for each 1-kg/m2 increase in BMI. Conclusion Admission BMI is significantly associated with delivery route in term laboring women. Parity and prior cesarean are other important predictors.