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• W2090908034 abstract "ObjectiveIncreasing body mass index (BMI) category has been associated with an increased risk of caesarean section. The role of differences in labor management among different BMI categories on the caesarean section rates has not yet been evaluated.Study designA cohort study was conducted using data from the McGill Obstetrics and Neonatal Database on deliveries taking place during a 10-year period excluding elective caesarean sections. BMI at delivery was categorized as underweight (<20), normal (20-24.9), overweight (25-29.9), obese (30-39.9), and morbidly obese (40+). The effect of the management of labor on the need for caesarean section was evaluated using unconditional logistic regression models.ResultsData was available for 12,153 women of whom 2,324 women were normal weight, 5,850 were overweight, 3,766 were obese, and 249 were morbidly obese. Increasing BMI category was found to be strongly associated with a decreasing 1st and 2nd stage time to caesarean section for dystocia. After adjusting for known confounding variables, increasing BMI category was associated with an overall increase in use of oxytocin, and increase in epidural use, and among second stage deliveries, a decrease in forceps and vacuum use. When modeled using logistic regression to adjust for these causal intermediates, the increasing rate of 2nd stage caesarean sections observed with increasing BMI category was markedly attenuated 1.44 (1.18-1.75) to 1.29 (1.04-1.61), p<0.001.ConclusionWomen with increasing BMI category are differently managed in labor. This difference in management in part explains the increased rate of 2nd stage caesarean sections observed with increasing BMI category. ObjectiveIncreasing body mass index (BMI) category has been associated with an increased risk of caesarean section. The role of differences in labor management among different BMI categories on the caesarean section rates has not yet been evaluated. Increasing body mass index (BMI) category has been associated with an increased risk of caesarean section. The role of differences in labor management among different BMI categories on the caesarean section rates has not yet been evaluated. Study designA cohort study was conducted using data from the McGill Obstetrics and Neonatal Database on deliveries taking place during a 10-year period excluding elective caesarean sections. BMI at delivery was categorized as underweight (<20), normal (20-24.9), overweight (25-29.9), obese (30-39.9), and morbidly obese (40+). The effect of the management of labor on the need for caesarean section was evaluated using unconditional logistic regression models. A cohort study was conducted using data from the McGill Obstetrics and Neonatal Database on deliveries taking place during a 10-year period excluding elective caesarean sections. BMI at delivery was categorized as underweight (<20), normal (20-24.9), overweight (25-29.9), obese (30-39.9), and morbidly obese (40+). The effect of the management of labor on the need for caesarean section was evaluated using unconditional logistic regression models. ResultsData was available for 12,153 women of whom 2,324 women were normal weight, 5,850 were overweight, 3,766 were obese, and 249 were morbidly obese. Increasing BMI category was found to be strongly associated with a decreasing 1st and 2nd stage time to caesarean section for dystocia. After adjusting for known confounding variables, increasing BMI category was associated with an overall increase in use of oxytocin, and increase in epidural use, and among second stage deliveries, a decrease in forceps and vacuum use. When modeled using logistic regression to adjust for these causal intermediates, the increasing rate of 2nd stage caesarean sections observed with increasing BMI category was markedly attenuated 1.44 (1.18-1.75) to 1.29 (1.04-1.61), p<0.001. Data was available for 12,153 women of whom 2,324 women were normal weight, 5,850 were overweight, 3,766 were obese, and 249 were morbidly obese. Increasing BMI category was found to be strongly associated with a decreasing 1st and 2nd stage time to caesarean section for dystocia. After adjusting for known confounding variables, increasing BMI category was associated with an overall increase in use of oxytocin, and increase in epidural use, and among second stage deliveries, a decrease in forceps and vacuum use. When modeled using logistic regression to adjust for these causal intermediates, the increasing rate of 2nd stage caesarean sections observed with increasing BMI category was markedly attenuated 1.44 (1.18-1.75) to 1.29 (1.04-1.61), p<0.001. ConclusionWomen with increasing BMI category are differently managed in labor. This difference in management in part explains the increased rate of 2nd stage caesarean sections observed with increasing BMI category. Women with increasing BMI category are differently managed in labor. This difference in management in part explains the increased rate of 2nd stage caesarean sections observed with increasing BMI category." @default.
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• W2090908034 title "Increased cesarean section rates with increasing body mass index" @default.
• W2090908034 doi "https://doi.org/10.1016/j.ajog.2006.10.792" @default.
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