Stefania Ronzoni1, Hadar Rosen1, Nir Melamed2, Shay Porat3, Dan Farine1, Cynthia Maxwell1. 1. Division of Feto Maternal Medicine, Department of Obstetric and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. 2. Division of Feto Maternal Medicine, Department of Obstetric and Gynecology, Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada. 3. Department of Obstetrics and Gynecology, Hadassah-Hebrew, University Medical Center, Mt Scopus Campus, Jerusalem, Israel.
Abstract
OBJECTIVE: To assess the impact of body mass index (BMI) on the rate of cesarean section (rCS) in induction of labor (IOL). STUDY DESIGN: A total of 7,543 singleton term pregnancies undergoing IOL (cervical dilatation at admission, CDA ≤ 3 cm) were divided according to BMI: underweight (n = 325); normal weight (NW) (n = 4,633); overweight (OW) (n = 1,610); and obese (n = 975). Age, parity, macrosomia, gestational age (GA), gestational weight gain (GWG), CDA, and IOL indications were considered. RESULTS: A higher rate of macrosomia (15.0 vs. 11.1%; p < 0.0001), earlier induction (GA 39.7 ± 1.3 vs. 40.1 ± 1.3 weeks; p < 0.0001) for maternal indications (39.1 vs. 21.1%; p < 0.001), and lower CDA (≤1cm; 66.4 vs. 61.4%; p < 0.005) were observed in obese versus NW. The rate of weight gain above the recommended range was higher in obese (obese 70.6% vs. NW 43.9%; p < 0.001), despite a significantly lower mean GWG compared with NW (14 ± 7.5 vs. 16.5 ± 5.6 kg; p < 0.001). Compared with NW, OW and obese demonstrated a significantly higher rCS (OW 31.1% and obese 36.9% vs. NW 24.7%; p < 0.001). BMI represented an independent factor affecting the rCS (vs. NW; OW odds ratio [OR] 1.4; confidence interval [CI] 1.2-1.7; p < 0.001; obese OR 2.3; CI 1.9-2.7 p < 0.001). CONCLUSION: In the case of IOL, obesity represents an independent factor associated with a significant increase of CS to be considered during induction counselling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To assess the impact of body mass index (BMI) on the rate of cesarean section (rCS) in induction of labor (IOL). STUDY DESIGN: A total of 7,543 singleton term pregnancies undergoing IOL (cervical dilatation at admission, CDA ≤ 3 cm) were divided according to BMI: underweight (n = 325); normal weight (NW) (n = 4,633); overweight (OW) (n = 1,610); and obese (n = 975). Age, parity, macrosomia, gestational age (GA), gestational weight gain (GWG), CDA, and IOL indications were considered. RESULTS: A higher rate of macrosomia (15.0 vs. 11.1%; p < 0.0001), earlier induction (GA 39.7 ± 1.3 vs. 40.1 ± 1.3 weeks; p < 0.0001) for maternal indications (39.1 vs. 21.1%; p < 0.001), and lower CDA (≤1cm; 66.4 vs. 61.4%; p < 0.005) were observed in obese versus NW. The rate of weight gain above the recommended range was higher in obese (obese 70.6% vs. NW 43.9%; p < 0.001), despite a significantly lower mean GWG compared with NW (14 ± 7.5 vs. 16.5 ± 5.6 kg; p < 0.001). Compared with NW, OW and obese demonstrated a significantly higher rCS (OW 31.1% and obese 36.9% vs. NW 24.7%; p < 0.001). BMI represented an independent factor affecting the rCS (vs. NW; OW odds ratio [OR] 1.4; confidence interval [CI] 1.2-1.7; p < 0.001; obese OR 2.3; CI 1.9-2.7 p < 0.001). CONCLUSION: In the case of IOL, obesity represents an independent factor associated with a significant increase of CS to be considered during induction counselling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Valentin Nicolae Varlas; Georgiana Bostan; Bogdana Adriana Nasui; Nicolae Bacalbasa; Anca Lucia Pop Journal: Healthcare (Basel) Date: 2021-04-14