Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta-analysis of cohort studies

  1. A. S. Poobalan1,
  2. L. S. Aucott1,
  3. T. Gurung1,
  4. W. C. S. Smith1,
  5. S. Bhattacharya2,*

Article first published online: 30 OCT 2008

DOI: 10.1111/j.1467-789X.2008.00537.x

Issue

Obesity Reviews

Obesity Reviews

Volume 10, Issue 1, pages 28–35, January 2009

Additional Information

How to Cite

Poobalan, A. S., Aucott, L. S., Gurung, T., Smith, W. C. S. and Bhattacharya, S. (2009), Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta-analysis of cohort studies. Obesity Reviews, 10: 28–35. doi: 10.1111/j.1467-789X.2008.00537.x

Author Information

  1. 1

    Department of Public Health, University of Aberdeen;

  2. 2

    Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Aberdeen, UK

*Sohinee Bhattacharya, Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZD, UK. E-mail: sohinee.bhattacharya@abdn.ac.uk

Publication History

  1. Issue published online: 23 DEC 2008
  2. Article first published online: 30 OCT 2008
  3. Received 1 July 2008; revised 3 September 2008; accepted 29 September 2008

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Keywords:

  • Body mass index;
  • elective and emergency caesarean delivery;
  • obesity;
  • overweight

Summary

The objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta-analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for ‘pregnancy’, ‘obesity’, ‘overweight,’‘body mass index’ and ‘caesarean section’ were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20–25 kg m−2), the crude pooled odds ratios (95% confidence intervals) for caesarean section in overweight (BMI 25–30 kg m−2), obese (BMI 30–35 kg m−2) and morbidly obese (BMI > 35 kg m−2) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95% confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50% in overweight women and is more than double for obese women compared with women with normal BMI.

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