Pregestational obesity, maternal morbidity and risk of caesarean delivery in a country in an advanced stage of obstetric transition

María Begoña Carroza Escobar; Jovita Ortiz Contreras; María Paz Bertoglia; Marcela Araya Bannout

doi:10.1016/j.orcp.2020.12.006

Pregestational obesity, maternal morbidity and risk of caesarean delivery in a country in an advanced stage of obstetric transition

Obes Res Clin Pract. 2021 Jan-Feb;15(1):73-77. doi: 10.1016/j.orcp.2020.12.006. Epub 2020 Dec 31.

Authors

María Begoña Carroza Escobar¹, Jovita Ortiz Contreras², María Paz Bertoglia³, Marcela Araya Bannout⁴

Affiliations

¹ Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Avda. Independencia 1027, Santiago, Chile; Grupo Transdisciplinario de Obesidad de Poblaciones-GTOP (Transdisciplinary Group for Population Obesity), University of Chile, Chile. Electronic address: mariabego@uchile.cl.
² Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Avda. Independencia 1027, Santiago, Chile; Immigration and Health Research Group, Faculty of Medicine, University of Chile, Chile. Electronic address: jortizc@uchile.cl.
³ Population Nutrition Program, School of Public Health, Faculty of Medicine, University of Chile, Avda. Independencia 939, Santiago, Chile; Grupo Transdisciplinario de Obesidad de Poblaciones-GTOP (Transdisciplinary Group for Population Obesity), University of Chile, Chile. Electronic address: mbertoglia@ucn.cl.
⁴ Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Avda. Independencia 1027, Santiago, Chile; Grupo Transdisciplinario de Obesidad de Poblaciones-GTOP (Transdisciplinary Group for Population Obesity), University of Chile, Chile. Electronic address: marbannout@uchile.cl.

PMID: 33390323
DOI: 10.1016/j.orcp.2020.12.006

Abstract

Objective: To evaluate whether pregestational obesity is associated with the risk of caesarean section in pregnant women living in a country in an advanced stage of the obstetric transition.

Methods: Retrospective cohort study. Data were collected from prenatal and hospital records. Pregestational obesity was defined as: body mass index, [weight(k)/height (m²)] ≥30, and caesarean sections were categorized as elective, emergency, or non-emergency/medically necessary. Biodemographic and sociodemographic characteristics, obstetric and perinatal pathologies, and maternal anthropometric variables were assessed. Chi-square and t-tests were used to compare qualitative and quantitative variables, respectively. Simple and adjusted generalized linear models were used to evaluate the association between pregestational obesity and caesarean delivery. Finally, population attributable risk was calculated. Data analysis was performed using STATA.v.14.0.

Participants: 2309 pregnant women with a singleton pregnancy who gave birth at a public hospital in the Metropolitan Region of Santiago, Chile in 2015.

Results: The prevalence of pregestational obesity was 21.4%, and the incidence of caesarean deliveries was 34.8% (33% of which corresponded to elective, 46% to emergency, and 21% to non-emergency/medically necessary caesarean deliveries). Pregestational obesity increased the risk of caesarean delivery (aRR = 1.46; 95%CI. [1.19-1.79] as well as the risk of elective (aRR = 1.74; 95%CI. [1.23-2.45]) and emergency caesarean delivery (aRR = 1.44; 95%CI. [1.03-2.00]). The population attributable risk of pregestational obesity for caesarean section was 32%.

Conclusion: Given the significant association between pregestational obesity and caesarean delivery, it is necessary to develop strategies to decrease obesity among women of childbearing age in order to decrease obstetric intervention.

Keywords: Caesarean section; Elective caesarean section; Emergency caesarean section; Maternal obesity; Obstetric transition.

MeSH terms

Body Mass Index
Cesarean Section*
Chile / epidemiology
Female
Humans
Obesity* / epidemiology
Pregnancy
Retrospective Studies
Risk Factors