Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Obstetrics, Oslo University Hospital, Oslo, Norway.
Acta Obstet Gynecol Scand. 2018 Feb;97(2):212-218. doi: 10.1111/aogs.13265. Epub 2017 Dec 14.
High maternal body mass index (BMI) is associated with complications during pregnancy and delivery such as gestational diabetes, hypertensive disorders, perineal injuries and macrosomia. The aim of this study was to assess the association between maternal BMI and delivery method in non-breech, singleton deliveries, after 36 weeks of gestation, in women with no more than one previous cesarean section, in Oslo University Hospital, Ullevål.
This retrospective register study used data from the hospital obstetrical database in 2011-2012, forming a cohort of 8821 women. Women were categorized into five different BMI classes and stratified into subgroups according to parity and previous cesarean delivery. Mode of delivery was categorized to spontaneous delivery, instrumental vaginal delivery, planned cesarean section and emergency cesarean section.
Incidence of emergency cesarean delivery increased with increasing maternal BMI. Among primiparous women with overweight or obesity, the caesarean delivery rate was doubled (23.2 and 29.1%, respectively), compared with women with underweight or normal weight (12.5 and 13.7%). Also among parous women, maternal BMI ≥30 doubled the risk for cesarean delivery. The strongest risk factor for planned or emergency cesarean delivery was previous cesarean section [adjusted odds ratio 16.41 (confidence interval 12.19-22.08) and 8.72 (6.33-12.02), respectively]. Maternal BMI ≥30 increased the risk of planned cesarean delivery by 77%, and doubled the risk of emergency cesarean delivery.
Prepregnancy BMI ≥30 was an independent risk factor for delivery by emergency cesarean section for both primiparous and parous women.
高母体体重指数（BMI）与妊娠和分娩期间的并发症有关，例如妊娠糖尿病、高血压疾病、会阴损伤和巨大儿。本研究的目的是评估在奥斯陆大学医院 Ullevål 接受过一次剖宫产的、无多胎妊娠的、36 周后非臀位、单胎分娩的孕妇中，母体 BMI 与分娩方式之间的关联。
这是一项回顾性登记研究，使用了 2011-2012 年医院产科数据库的数据，形成了一个 8821 名女性的队列。将女性分为五个不同的 BMI 类别，并根据产次和既往剖宫产进行分层分组。分娩方式分为自然分娩、器械性阴道分娩、计划性剖宫产和紧急剖宫产。
随着母体 BMI 的增加，紧急剖宫产的发生率增加。在超重或肥胖的初产妇中，剖宫产率增加了一倍（分别为 23.2%和 29.1%），而体重不足或正常体重的产妇分别为 12.5%和 13.7%。在多产妇中，BMI≥30 使剖宫产的风险增加一倍。计划性或紧急剖宫产的最强危险因素是既往剖宫产史[调整后的优势比分别为 16.41（置信区间 12.19-22.08）和 8.72（6.33-12.02）]。BMI≥30 使计划性剖宫产的风险增加了 77%，使紧急剖宫产的风险增加了一倍。
孕前 BMI≥30 是初产妇和经产妇紧急剖宫产的独立危险因素。
