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Maternal body mass index as a predictor for delivery method.

Anita Pettersen-Dahl1, Gulim Murzakanova2, Leiv Sandvik1,3

  • 1Faculty of Medicine, University of Oslo, Oslo, Norway.

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PubMed
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High maternal body mass index (BMI) significantly increases the risk of emergency cesarean delivery, especially for women with obesity. This finding highlights the importance of weight management for safer pregnancy outcomes.

Keywords:
Body mass indexcesarean deliveryinstrumental deliveryobesityoverweight

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Public Health

Background:

  • High maternal body mass index (BMI) is linked to increased pregnancy and delivery complications.
  • Complications include gestational diabetes, hypertensive disorders, perineal injuries, and macrosomia.

Purpose of the Study:

  • To investigate the association between maternal BMI and delivery method.
  • Focus on non-breech, singleton deliveries after 36 weeks gestation.
  • Inclusion criteria: women with no more than one prior cesarean section.

Main Methods:

  • Retrospective register study using hospital obstetrical database (2011-2012).
  • Cohort of 8821 women categorized by BMI class, parity, and previous cesarean delivery.
  • Delivery modes: spontaneous, instrumental vaginal, planned cesarean, and emergency cesarean.

Main Results:

  • Emergency cesarean delivery incidence rose with increasing maternal BMI.
  • Overweight/obese primiparous women had doubled cesarean rates (23.2% and 29.1%) compared to normal weight (12.5-13.7%).
  • Maternal BMI ≥30 doubled cesarean risk in parous women and increased planned cesarean by 77%, emergency by 100%.

Conclusions:

  • Prepregnancy BMI ≥30 is an independent risk factor for emergency cesarean delivery.
  • This risk applies to both primiparous and parous women.
  • Previous cesarean section remains the strongest risk factor for both planned and emergency cesarean delivery.