The maternal body mass index: a strong association with delivery route.
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.
Kominiarek
Michelle A
MA
Indiana University Clarian Health, Indianapolis, IN, USA.
Vanveldhuisen
Paul
P
Hibbard
Judith
J
Landy
Helain
H
Haberman
Shoshana
S
Learman
Lee
L
Wilkins
Isabelle
I
Bailit
Jennifer
J
Branch
Ware
W
Burkman
Ronald
R
Gonzalez-Quintero
Victor Hugo
VH
Gregory
Kimberly
K
Hatjis
Christos
C
Hoffman
Matthew
M
Ramirez
Mildred
M
Reddy
Uma M
UM
Troendle
James
J
Zhang
Jun
J
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