Extreme obesity and postcesarean maternal complications

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Outcomes Research

Background:

• Cesarean delivery is a common surgical procedure with potential maternal complications.
• Obesity is a growing public health concern, affecting a significant portion of pregnant individuals.
• Understanding the impact of varying degrees of obesity on post-cesarean complications is crucial for patient care.

Purpose of the Study:

• To investigate the association between obesity and extreme obesity with maternal complications following cesarean delivery.
• To quantify the increased risk of specific complications in relation to body mass index (BMI) categories.

Main Methods:

• Secondary cohort analysis of a randomized controlled trial involving 585 women.
• Obesity was stratified into normal/overweight (BMI <30), obese (BMI 30-45), and extremely obese (BMI >45).
• Logistic regression analyses were used to determine adjusted odds ratios (ORs) for composite infectious outcomes and other complications.

Main Results:

• Increasing obesity severity correlated with higher rates of comorbidities, longer operative durations, and specific incision types.
• Extremely obese patients (BMI >45) experienced a two- to fourfold increase in postoperative complications.
• Key complications included infectious outcomes (OR 2.7), wound infections (OR 3.4), and emergency department visits (OR 2.2).

Conclusions:

• Maternal extreme obesity is significantly associated with an increased risk of post-cesarean wound complications.
• These findings underscore the heightened morbidity associated with extreme obesity in patients undergoing cesarean birth.
• Risk stratification and tailored management strategies are warranted for extremely obese women delivering via cesarean.