Obesity and gestational weight gain: cesarean delivery and labor complications
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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Faculdade de Saúde Pública da Universidade de São Paulo
2006
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oai:scielo:S0034-891020060003000142006-08-16Obesity and gestational weight gain: cesarean delivery and labor complicationsSeligman,Luiz CarlosDuncan,Bruce BartholowBranchtein,LeandroGaio,Dea Suzana MirandaMengue,Sotero SerrateSchmidt,Maria Inês Cohort studies Obesity/epidemiology Weight gain Pregnancy Labor, premature/epidemiology Labor complications/epidemiology Cesarean section Postpartum hemorrhage Meconium Perinatal mortality 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.info:eu-repo/semantics/openAccessFaculdade de Saúde Pública da Universidade de São PauloRevista de Saúde Pública v.40 n.3 20062006-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102006000300014en10.1590/S0034-89102006000300014 |
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Seligman,Luiz Carlos Duncan,Bruce Bartholow Branchtein,Leandro Gaio,Dea Suzana Miranda Mengue,Sotero Serrate Schmidt,Maria Inês |
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Seligman,Luiz Carlos Duncan,Bruce Bartholow Branchtein,Leandro Gaio,Dea Suzana Miranda Mengue,Sotero Serrate Schmidt,Maria Inês Obesity and gestational weight gain: cesarean delivery and labor complications |
author_facet |
Seligman,Luiz Carlos Duncan,Bruce Bartholow Branchtein,Leandro Gaio,Dea Suzana Miranda Mengue,Sotero Serrate Schmidt,Maria Inês |
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Seligman,Luiz Carlos |
title |
Obesity and gestational weight gain: cesarean delivery and labor complications |
title_short |
Obesity and gestational weight gain: cesarean delivery and labor complications |
title_full |
Obesity and gestational weight gain: cesarean delivery and labor complications |
title_fullStr |
Obesity and gestational weight gain: cesarean delivery and labor complications |
title_full_unstemmed |
Obesity and gestational weight gain: cesarean delivery and labor complications |
title_sort |
obesity and gestational weight gain: cesarean delivery and labor complications |
description |
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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Faculdade de Saúde Pública da Universidade de São Paulo |
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2006 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102006000300014 |
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