title: Indications of caesarean section in overweight and obese versus normal-weight pregnant women: a retrospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to test the hypothesis that indications of c-section in overweight or obese pregnant women are different from those with normal-weight.
  
  
  METHODS
  Retrospective cohort study at University Hospital of Puerto Real (Cádiz-Spain). We compared frequency distribution of c-section indications in overweight and obese versus normal-weight. The risk of c-section by different indications was calculated as relative risk.
  
  
  RESULTS
  A total of 4685 births were included in the study. There are significant differences in the frequency distribution of caesarean indications among normal weight and overweight or obese women. In overweight, we found an increased risk of c-section due to previous c-section (RR: 1.73; confidence interval [CI] 95% 1.24-2.42), obstructed/non-progressive labour (RR: 1.34; CI 95% 1.03-1.75), failed induction of labour (RR: 2.38; CI 95% 1.30-4.34) and foetal distress (RR: 1.73; CI 95% 1.21-2.49). This risk was even higher in obese women: previous c-section (RR: 3.25; CI 95% 2.24-4.71), obstructed/non-progressive labour (RR: 2; CI 95% 1.45-2.77), failed induction (RR: 2.52; CI 95% 1.15-5.51) and foetal distress (RR: 2.35; CI 95% 1.51-3.65).
  
  
  CONCLUSIONS
  The risk of caesarean section due to previous caesarean section, obstructed/non-progressive labour, failed induction of labour or foetal distress is greater in overweight and obese than in normal-weight. This increase in risk also increases progressively as maternal BMI increases.
authors.affiliation: a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
authors.forename: Juan Jesús
authors.identifier: http://orcid.org/0000-0002-7297-6876
authors.initials: JJ
authors.lastname: Fernández Alba
authors.affiliation: b Enfermería y Fisioterapia , Universidad de Cadiz , Cadiz , Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Paublete Herrera
authors.affiliation: a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Vilar Sanchez
authors.affiliation: a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gonzalez-Macias
authors.affiliation: a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Castillo Lara
authors.affiliation: a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Torrejón
authors.affiliation: b Enfermería y Fisioterapia , Universidad de Cadiz , Cadiz , Spain.
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Moreno Corral
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
keywords: Obesity; body mass index; caesarean section; indications; overweight