Author(s)

Annelee Boyle^1*, Julia Timofeev², Sameer Desale³, Rita W. Driggers², Donald J. Dudley⁴

¹Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington DC, USA.
²Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³MedStar Health Research Institute, Hyattsville, MD, USA.
⁴Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, VA, USA.

Objective: To evaluate the relationship between weight gain and primary cesarean delivery. Methods: This was a retrospective cohort study of women 5442 who delivered a singleton from 2009-2013. Women were classified as normal weight [pre-pregnancy body mass index (BMI) 18.5 - 24.9 kg/m²], overweight (pre-pregnancy BMI 25.0 - 29.9 kg/m²), obese (pre-pregnancy BMI 30.0 - 39.9 kg/m²), and extremely obese (pre-pregnancy BMI ≥ 40.0 kg/m²). Each BMI group was subdivided by weight gain—low, recommended, or excessive, as defined by the 2009 Institute of Medicine guidelines—and rates of primary cesarean delivery were compared. Results: The overall primary cesarean delivery rate was 27.3%, but this varied based on pre-pregnancy BMI. The primary cesarean delivery rate among women of normal weight was 22.3%, overweight women 27.5%, obese women 35.3%, and extremely obese women 45.7%. Among normal-weight, obese, and extremely obese women, the risk of primary cesarean delivery increased with excessive weight gain [normal weight odds ratio (OR) 1.63, (95% confidence interval 1.32 - 2.01); obese OR 1.55 (1.12 - 2.15); extremely obese OR 2.19 (1.18 - 4.08)] compared to recommended weight gain. More than half of women (53.2%) had excessive weight gain. Conclusion: Adherence to guidelines may decrease a woman’s risk of primary cesarean delivery.

Primary Cesarean, Weight Gain, Pre-Pregnancy BMI, Obese, Obesity

Boyle, A. , Timofeev, J. , Desale, S. , Driggers, R. and Dudley, D. (2017) Weight Gain: A Modifiable Risk Factor for Primary Cesarean Delivery. Open Journal of Obstetrics and Gynecology, 7, 525-531. doi: 10.4236/ojog.2017.75055.