Influence of obesity on route of delivery in a population of African descent in Martinique.
OBJECTIVE
To determine whether obesity is an independent risk factor for cesarean delivery in Martinique.


METHODS
A retrospective study was performed using data for deliveries that occurred at the University Hospital of Fort de France between January and September 2010. Women were divided into four groups on the basis of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters; < 25 [group 1], 25-29 [group 2], 30-39 [group 3], and ≥ 40 [group 4]). Independent risk factors for cesarean delivery were identified through multivariate analysis.


RESULTS
Overall, 1286 women were included. Mean weight gain was lower in groups 2 (9.9 kg, 95% CI 9.2-10.7), 3 (5.7 kg, 4.7-6.7), and 4 (1.0 kg,-1.5 to 3.5), than in group 1 (12.3 kg, 11.9-12.7; P < 0.001 for all). In univariate analysis, cesarean deliveries were more frequent among nulliparous women in group 2 (P = 0.007) and group 3 (P = 0.053) than among those in group 1. In multivariate analysis, BMI was not associated with cesarean delivery (BMI 25-29: adjusted odds ratio 0.64, 95% CI 0.33-1.25; BMI ≥ 30: 0.61, 0.29-1.39).


CONCLUSIONS
Obesity was not an independent risk factor for cesarean delivery. Weight control and a positive attitude towards trial of labor in obese women could have led to the findings.
Department of Obstetrics, Pôle Femme-Mère-Enfant, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique. Electronic address: jean-luc.volumenie@chu-fortdefrance.fr.
Jean-Luc
JL
Volumenie
Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire la Milétrie, Poitiers, France.
David
D
Desseauve
Department of Obstetrics, Pôle Femme-Mère-Enfant, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique.
Olivier
O
Flechelles
D000328:Adult; D044383:Black People; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D008395:Martinique; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications*; D007744:Obstetric Labor Complications / Q000209:etiology*; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014219:Trial of Labor; D015430:Weight Gain
African descent; Cesarean delivery; Instrumental delivery; Obesity