Interpregnancy Body Mass Index Change and Risk of Intrapartum Cesarean Delivery

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Maternal-Fetal Medicine

Background:

• Interpregnancy weight change is a significant factor in maternal health.
• Previous cesarean delivery history is a key exclusion criterion in studies on subsequent delivery modes.
• Understanding the impact of interpregnancy body mass index (BMI) changes on delivery outcomes is crucial for clinical practice.

Purpose of the Study:

• To investigate the association between interpregnancy body mass index (BMI) change and intrapartum cesarean delivery.
• To determine if weight loss or gain between pregnancies affects the likelihood of cesarean delivery in women without prior cesarean history.

Main Methods:

• Retrospective cohort study of multiparous women (2009-2018).
• Exclusion of women with prior cesarean delivery or contraindications for vaginal birth.
• Categorization of interpregnancy BMI change (loss >2 kg/m², change ±2 kg/m², gain >2 kg/m²) and analysis of intrapartum cesarean delivery rates using multivariable logistic regression.

Main Results:

• Women with interpregnancy BMI gain (>2 kg/m²) showed increased odds of intrapartum cesarean delivery (aOR: 1.78; 95% CI: 1.10-2.86).
• BMI gain was also associated with higher rates of cesarean delivery for arrest disorders (aOR: 3.06; 95% CI: 1.30-7.15).
• Interpregnancy BMI loss (>2 kg/m²) was not significantly associated with intrapartum cesarean delivery rates compared to stable BMI.

Conclusions:

• Interpregnancy BMI gain is linked to a higher likelihood of intrapartum cesarean delivery.
• Maintaining or losing weight between pregnancies appears to be a safer approach regarding cesarean delivery risk.
• These findings suggest that managing weight between pregnancies may be beneficial for optimizing delivery outcomes.