Abstract
Objective: Our purpose was to evaluate whether maternal weight and body mass index measured
either before or during pregnancy are associated with an increased risk of cesarean
delivery. Study design: Maternal weight and height were prospectively collected on 2929 women in the National
Institutes of Health Maternal-Fetal Medicine Units Network Preterm Prediction Study.
Prepregnancy and 27- to 31-week maternal weight and height were used to calculate
the body mass index, and its contribution to the risk of cesarean delivery was determined.
Women with prenatally diagnosed congenital anomalies (n = 89) and pregestational diabetes (n = 31) were excluded from analysis. Results: Univariate analysis of risk factors for cesarean delivery in the 2809 eligible women
revealed a decreased risk of cesarean delivery with maternal age <18 years and multiparity;
increased risk of cesarean delivery was noted with maternal age >35 years and a male
fetus. Increases in either prepregnancy or 27- to 31-week maternal weight (5-pound
units) or body mass index (1.0 kg/m2 units) were significantly associated with an increased odds of cesarean delivery
(p = 0.0001). Each unit increase in prepregnancy or 27- to 31-week body mass index resulted
in a parallel increase in the odds of cesarean delivery of 7.0% and 7.8%, respectively.
Multivariable stepwise logistic regression analysis confirmed the association of male
fetus, age, nulliparity, and body mass index as significant variables contributing
to cesarean delivery risk. Conclusions: The risk of cesarean delivery is associated with incremental changes in maternal
weight and body mass index before and during pregnancy after adjustment for potential
confounding factors. Prepregnancy counseling about optimizing maternal weight and
monitoring weight gain during pregnancy to decrease the risk of cesarean delivery
are supported by this study. (Am J Obstet Gynecol 1997;177:333-41.)
Keywords
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Article Info
Footnotes
☆From the Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development.
☆☆Supported by grants No. HD21410, HD21414, HD27860, HD27861, HD27869, HD27883, HD27889, HD27905 HD27915, HD27917, and HD19897 from the National Institute of Child Health and Human Development.
★Reprint requests: Brian C. Brost, MD, Medical University of South Carolina, Department of Obstetrics and Gynecology, 171 Ashley Ave., Charleston, SC 29425-2233.
★★†Deceased.
♢6/6/83824
Identification
Copyright
© 1997 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
