Obesity and gestational weight gain: cesarean delivery and labor complications.

Full Abstract

OBJECTIVE:
To assess the association between pre-gestational obesity and weight gain with cesarean delivery and labor complications.

METHODS:
A total of 4,486 women 20-28 weeks pregnant attending general prenatal care clinics of the national health system in Brazil from 1991 to 1995 were enrolled and followed up through birth. Body mass index categories based on prepregnancy weight and total weight gain were calculated. Associations between body mass index categories and labor complications were adjusted through logistic regression analysis.

RESULTS:
Obesity was present in 308 (6.9%) patients. Cesarean delivery was performed in 164 (53.2%) obese, 407 (43.1%) pre-obese, 1,045 (35.1%) normal weight and 64 (24.5%) underweight women. The relative risk for cesarean delivery in obese women was 1.8 (95%

CI:
1.5-2.0) compared to normal weight women. Greater weight gain was particularly associated with cesarean among the obese (RR 4th vs 2nd weight gain quartile 2.2; 95%

CI:
1.4-3.2). Increased weight at the beginning of pregnancy was associated with a significantly higher adjusted risk of meconium with vaginal delivery and perinatal death and infection in women submitted to cesarean section. Similarly, greater weight gain during pregnancy increased the risk for meconium and hemorrhage in women submitted to vaginal delivery and for prematurity with cesarean.

CONCLUSIONS:
Pre-gestational obesity and greater weight gain independently increase the risk of cesarean delivery, as well as of several adverse outcomes with vaginal delivery. These findings provide further evidence of the negative effects of prepregnancy obesity and greater gestational weight gain on pregnancy outcomes.

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Author information

Author/s: Seligman, Luiz Carlos (LC); Duncan, Bruce Bartholow (BB); Branchtein, Leandro (L); Gaio, Dea Suzana Miranda (DS); Mengue, Sotero Serrate (SS); Schmidt, Maria Inês (MI);

Affiliation: Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. lc.seligman(-atsign-)brturbo.com.br

Journal and publication information

Publication Type: Journal Article

Journal: Revista de saúde pública (Rev Saude Publica), published in Brazil. (Language: eng)

Reference: 2006-Jun; vol 40 (issue 3) : pp 457-65

Dates: Created 2006/06/30; Completed 2007/04/19;

PMID: 16810370, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Body Mass Index
Brazil - epidemiology
Cesarean Section - statistics & numerical data
Educational Status
Female
Humans
Infant, Newborn
Logistic Models

Logistic Models
Obesity - complications; epidemiology
Obstetric Labor Complications - epidemiology; etiology
Pregnancy
Pregnancy Complications - epidemiology; etiology
Pregnancy Outcome - epidemiology
Risk
Weight Gain

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