title: The maternal body mass index: a strong association with delivery route.
abstract: OBJECTIVE
  We sought to assess body mass index (BMI) effect on cesarean risk during labor.
  
  
  METHODS
  The Consortium on Safe Labor collected electronic data from 228,668 deliveries. Women with singletons > or = 37 weeks and known BMI at labor admission were analyzed in this cohort study. Regression analysis generated relative risks for cesarean stratifying for parity and prior cesarean while controlling for covariates.
  
  
  RESULTS
  Of the 124,389 women, 14.0% had cesareans. Cesareans increased with increasing BMI for nulliparas and multiparas with and without a prior cesarean. Repeat cesareans were performed in > 50% of laboring women with a BMI > 40 kg/m(2). The risk for cesarean increased as BMI increased for all subgroups, P < .001. The risk for cesarean increased by 5%, 2%, and 5% for nulliparas and multiparas with and without a prior cesarean, respectively, for each 1-kg/m(2) increase in BMI.
  
  
  CONCLUSIONS
  Admission BMI is significantly associated with delivery route in term laboring women. Parity and prior cesarean are other important predictors.
authors.affiliation: Indiana University Clarian Health, Indianapolis, IN, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kominiarek
authors.forename: Paul
authors.initials: P
authors.lastname: Vanveldhuisen
authors.forename: Judith
authors.initials: J
authors.lastname: Hibbard
authors.forename: Helain
authors.initials: H
authors.lastname: Landy
authors.forename: Shoshana
authors.initials: S
authors.lastname: Haberman
authors.forename: Lee
authors.initials: L
authors.lastname: Learman
authors.forename: Isabelle
authors.initials: I
authors.lastname: Wilkins
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bailit
authors.forename: Ware
authors.initials: W
authors.lastname: Branch
authors.forename: Ronald
authors.initials: R
authors.lastname: Burkman
authors.forename: Victor Hugo
authors.initials: VH
authors.lastname: Gonzalez-Quintero
authors.forename: Kimberly
authors.initials: K
authors.lastname: Gregory
authors.forename: Christos
authors.initials: C
authors.lastname: Hatjis
authors.forename: Matthew
authors.initials: M
authors.lastname: Hoffman
authors.forename: Mildred
authors.initials: M
authors.lastname: Ramirez
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.forename: James
authors.initials: J
authors.lastname: Troendle
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D012008:Recurrence; D012044:Regression Analysis; D018570:Risk Assessment