Maternal obesity and risk of cesarean delivery: a meta-analysis

Authors

  • S. Y. Chu,

    Corresponding author
    1. Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23, 1600 Clifton Road, Atlanta, GA, USA,
      SY Chu, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop K-23, Atlanta, GA 30333, USA.
      E-mail: syc1@cdc.gov
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  • S. Y. Kim,

    1. Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23, 1600 Clifton Road, Atlanta, GA, USA,
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  • C. H. Schmid,

    1. Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington St., Boston, MA, USA.
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  • P. M. Dietz,

    1. Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23, 1600 Clifton Road, Atlanta, GA, USA,
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  • W. M. Callaghan,

    1. Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23, 1600 Clifton Road, Atlanta, GA, USA,
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  • J. Lau,

    1. Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington St., Boston, MA, USA.
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  • K. M. Curtis

    1. Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23, 1600 Clifton Road, Atlanta, GA, USA,
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  • Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

SY Chu, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Mailstop K-23, Atlanta, GA 30333, USA.
E-mail: syc1@cdc.gov

Summary

Despite numerous studies reporting an increased risk of cesarean delivery among overweight or obese compared with normal weight women, the magnitude of the association remains uncertain. Therefore, we conducted a meta-analysis of the current literature to provide a quantitative estimate of this association. We identified studies from three sources: (i) a PubMed search of relevant articles published between January 1980 and September 2005; (ii) reference lists of publications selected from the search; and (iii) reference lists of review articles published between 2000 and 2005. We included cohort designed studies that reported obesity measures reflecting pregnancy body mass, had a normal weight comparison group, and presented data allowing a quantitative measurement of risk. We used a Bayesian random effects model to perform the meta-analysis and meta-regression. Thirty-three studies were included. The unadjusted odd ratios of a cesarean delivery were 1.46 [95% confidence interval (CI): 1.34–1.60], 2.05 (95% CI: 1.86–2.27) and 2.89 (95% CI: 2.28–3.79) among overweight, obese and severely obese women, respectively, compared with normal weight pregnant women. The meta-regression found no evidence that these estimates were affected by selected study characteristics. Our findings provide a quantitative estimate of the risk of cesarean delivery associated with high maternal body mass.

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