Obesity, obstetric complications and cesarean delivery rate--a population-based screening study

Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, Saade G, Eddleman K, Carter SM, Craigo SD, Carr SR, D'Alton ME, FASTER Research Consortium

doi:10.1016/j.ajog.2003.09.058

Abstract

Objective

This study was undertaken to determine whether obesity is associated with obstetric complications and cesarean delivery.

Methods

A large prospective multicenter database was studied. Subjects were divided into 3 groups: body mass index (BMI) less than 30 (control), 30 to 34.9 (obese), and 35 or greater (morbidly obese). Groups were compared by using univariate and multivariable logistic regression analyses.

Results

The study included 16,102

Patients

3,752 control, 1,473 obese, and 877 morbidly obese patients. Obesity and morbid obesity had a statistically significant association with gestational hypertension (odds ratios [ORs] 2.5 and 3.2), preeclampsia (ORs 1.6 and 3.3), gestational diabetes (ORs 2.6 and 4.0), and fetal birth weight greater than 4000 g (ORs 1.7 and 1.9) and greater than 4500 g (ORs 2.0 and 2.4). For nulliparous patients, the cesarean delivery rate was 20.7% for the control group, 33.8% for obese, and 47.4% for morbidly obese patients.

Conclusion

Obesity is an independent risk factor for adverse obstetric outcome and is significantly associated with an increased cesarean delivery rate.