Quality of recovery after cesarean delivery in patients with Class III obesity: a prospective observational cohort...

With obesity, the post-operative period is characterized by an increased and prolonged inflammatory response. This study evaluated the impact of obesity on postpartum recovery after elective cesarean delivery, using the Obstetric Quality of Recovery Score-10 (ObsQoR-10).

A prospective observational cohort study was conducted with 127 patients divided into two groups: Control (BMI <30) and High BMI (BMI >40 kg/m²). All patients received standardized care, including spinal anesthesia and multimodal analgesia. The primary outcome was the difference in ObsQoR-10 scores between the two groups 24 hours after surgery. Secondary outcomes included pain scores, total opioid consumption, incidence of adverse events, time to first mobilization, length of hospital stay, breastfeeding rates, and readmission rates.

Median (interquartile range) ObsQoR-10 scores at 24 hours were 83 (73.5-90.5) versus 82 (70-90) for the control group and the High BMI group, respectively. There were no significant differences in median 24-hour opioid consumption (0, 0 to 10, P=.078) between groups and in the median Numeric Rating Score for pain at 24 hours (0, -1 to 1) at rest (P=0.97) and on movement (P=0.78). There were no differences in length of stay or hospital readmission rates, however patients in the obesity group tended to breastfeed less and mobilize earlier than patients in the control group.

This study suggests minimal differences in the quality of recovery between the two groups. Future studies should examine recovery in patients with BMI >50, beyond 24 hours, and post-discharge.