Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women systematic review and meta-analysis of cohort studies

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Abstract

The objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta-analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for 'pregnancy', 'obesity', 'overweight,' 'body mass index' and 'caesarean section' were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20-25 kg m(-2)), the crude pooled odds ratios (95% confidence intervals) for caesarean section in overweight (BMI 25-30 kg m(-2)), obese (BMI 30-35 kg m(-2)) and morbidly obese (BMI > 35 kg m(-2)) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95% confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50% in overweight women and is more than double for obese women compared with women with normal BMI.

Original languageEnglish
Pages (from-to)28-35
Number of pages8
JournalObesity Reviews
Volume10
Issue number1
Early online date30 Oct 2008
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Body mass index
  • elective and emergency caesarean delivery
  • obesity
  • overweight
  • BODY-MASS INDEX
  • LARGE PRIVATE-PRACTICE
  • WEIGHT-GAIN
  • MATERNAL OBESITY
  • FAT DISTRIBUTION
  • PREGNANCY
  • COMPLICATIONS
  • MACROSOMIA
  • OVERWEIGHT
  • OUTCOMES

Cite this

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title = "Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women systematic review and meta-analysis of cohort studies",
abstract = "The objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta-analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for 'pregnancy', 'obesity', 'overweight,' 'body mass index' and 'caesarean section' were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20-25 kg m(-2)), the crude pooled odds ratios (95{\%} confidence intervals) for caesarean section in overweight (BMI 25-30 kg m(-2)), obese (BMI 30-35 kg m(-2)) and morbidly obese (BMI > 35 kg m(-2)) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95{\%} confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50{\%} in overweight women and is more than double for obese women compared with women with normal BMI.",
keywords = "Body mass index, elective and emergency caesarean delivery, obesity, overweight, BODY-MASS INDEX, LARGE PRIVATE-PRACTICE, WEIGHT-GAIN, MATERNAL OBESITY, FAT DISTRIBUTION, PREGNANCY, COMPLICATIONS, MACROSOMIA, OVERWEIGHT, OUTCOMES",
author = "Poobalan, {Amudha Sujatha} and Aucott, {Lorna Sharman} and Tara Gurung and Smith, {William Cairns Stewart} and Sohinee Bhattacharya",
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AU - Smith, William Cairns Stewart

AU - Bhattacharya, Sohinee

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AB - The objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta-analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for 'pregnancy', 'obesity', 'overweight,' 'body mass index' and 'caesarean section' were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20-25 kg m(-2)), the crude pooled odds ratios (95% confidence intervals) for caesarean section in overweight (BMI 25-30 kg m(-2)), obese (BMI 30-35 kg m(-2)) and morbidly obese (BMI > 35 kg m(-2)) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95% confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50% in overweight women and is more than double for obese women compared with women with normal BMI.

KW - Body mass index

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KW - overweight

KW - BODY-MASS INDEX

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KW - WEIGHT-GAIN

KW - MATERNAL OBESITY

KW - FAT DISTRIBUTION

KW - PREGNANCY

KW - COMPLICATIONS

KW - MACROSOMIA

KW - OVERWEIGHT

KW - OUTCOMES

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DO - 10.1111/j.1467-789X.2008.00537.x

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VL - 10

SP - 28

EP - 35

JO - Obesity Reviews

JF - Obesity Reviews

SN - 1467-7881

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