A new and significant study suggests that the greater a womans weight when she checks in on delivery day, the likelier a cesarean delivery.
The study involved data from nearly 125,000 women who gave birth between 2002 and 2008. This data was carefully analyzed to determine how other factors than a woman’s body mass index (BMI) might alter c section risk, such as prior births or cesarean sections. Additionally they analyzed the circumstances surrounding each birth, as well as the delivery route.
The study found that for every unit increase in BMI, as measured on arrival for delivery, a woman’s risk of cesarean delivery rose by 4 percent.
It was also found that this risk changed depending on whether or not a woman had given birth before or had previously undergone a cesarean section. A one-unit increase in BMI raised the risk of cesarean 5 percent for a woman delivering her first child, 2 percent for women with children and prior cesarean, and 5 percent for women with children but without a prior cesarean
These variables remained after accounting for factors such as maternal age, race and cervical dilation at hospital admission.
For those who had a prior cesarean, the risk of having another was about double: more than half of laboring women with a BMI over 40 (considered morbidly obese).
Significant in the perceived need for repeat cesareans is concern that a vaginal birth will tear scars left by the earlier c section. However, a different study recently discovered that such uterine ruptures are not as common as previously thought. In fact they occur in less than one percent of vaginal births after cesarean.
Lead researcher Dr. Michelle Kominiarek of Indiana University warned that exactly how obesity contributes to cesarean risk still has not been well addressed, but that it is a factor of significance is clear.
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