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

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• 作者：Michelle A. Kominiarek ; Paul VanVeldhuisen ; Judith Hibbard ; Helain L ; y ; Shoshana Haberman ; Lee Learman ; Isabelle Wilkins ; Jennifer Bailit ; Ware Branch ; Ronald Burkman ; Victor Hugo Gonzalez-Quintero ; Kimberly Gregory ; Christos Hatjis ; Matthew Hoffman ; Mildred Ramirez ; Uma M. Reddy ; James Troendle ; Ju
• 关键词：body mass index ; cesarean delivery ; obesity
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：203
• 期：3
• 页码：264.e1-264.e7
• 全文大小：307 K

文摘

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.