The Effect of Body Mass Index on Cesarean Delivery Rate in Korean Women.

Kim, Kun Woo; Jun, Jong Kwan

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Original Article

Korean Journal of Obstetrics & Gynecology 2006;49(10):2104-2111.
Published online October 1, 2006.

The Effect of Body Mass Index on Cesarean Delivery Rate in Korean Women.

Department of Obstetrics and Gynecology, Seoul National University, College of Medicine, Seoul, Korea. jhs0927@snu.ac.kr

Abstract

OBJECTIVE
To evaluate the effect of maternal BMI on the risk of cesarean delivery and to determine the threshold BMI at which the rate of cesarean delivery increased in Korean population. METHODS: Retrospectively we reviewed data on all nulliparous women who delivered live-born singleton infant in Seoul National University Hospital between Jan. 2000 and Dec. 2002. We included only term pregnancy with AGA (appropriate for gestational age) neonates and excluded all other pregnancy of indicated cesarean delivery except dystocia to show the pure effect of BMI. Cesarean delivery group were compared with vaginal delivery group with regard to maternal pre-gestational and pre-delivery BMI. RESULTS: We identified 1,041 eligible women. When pre-gestational BMI < or =20 was used as reference, the adjusted ORs and 95% confidence interval (CI) were 1.798 (1.088, 2.971) for 2024, respectively. When pre-delivery BMI< or =26 was used as reference, adjusted ORs and 95% CI were 1.761 (1.042, 2.978) for 2630, respectively. Using logistic regression model, independent risk factors for cesarean delivery were maternal age, epidural anesthesia, birth weight and pre-delivery BMI. CONCLUSION: In Korean women, the thresholds of pre-gestational and pre-delivery BMI at which the rate of cesarean delivery increased were 20 and 26, respectively. Although pre-gestational and pre-delivery BMI were risk factors of cesarean delivery, pre-delivery BMI was more important than pre-gestational BMI. We suggest that maintaining appropriate pre-delivery BMI may be a way to reduce the rate of cesarean delivery.

Key Words: Body mass index, Cesarean delivery, Pregnancy

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