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The impact of maternal obesity and weight gain on vaginal birth after cesarean section success.
Am J Obstet Gynecol. 2004 Sep; 191(3):954-7.AJ

Abstract

OBJECTIVE

This study was undertaken to determine the impact of maternal obesity on success of a trial of labor (vaginal birth after cesarean section [VBAC]) after a single low transverse cesarean delivery.

STUDY DESIGN

Individual charts of women with low transverse cesarean delivery in their first viable pregnancy who underwent a VBAC in their second viable pregnancy at our urban tertiary care institution were reviewed. Maternal body mass index (BMI) was classified as underweight (<19.8 kg/m2), normal (19.8-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (> or =30 kg/m2). Clinical characteristics and labor outcomes were assessed. Factors potentially affecting VBAC success were analyzed by univariate analysis. Logistic regressions were performed to determine the impact of maternal pregravid BMI on VBAC success after controlling for confounding factors.

RESULTS

Of 510 women attempting a trial of labor, 337 (66%) were successful and 173 (34%) failed VBAC. Decreased VBAC success was seen in obese (54.6%) but not overweight (65.5%) women compared with women of normal BMI (70.5%), P = .003 and .36, respectively. Underweight women had more VBAC success than women of normal BMI (84.7% vs 70.5%, P = .04). Controlling for other factors, the association between increasing pregravid BMI and BMI > or =30 kg/m 2 with decreased VBAC success persisted, P = .03 and .006, respectively. Normal BMI women who became overweight before the second pregnancy had decreased VBAC success compared with those whose BMI remained normal (56.6% vs 74.2%, P = .006). However, overweight women who decreased their BMI to normal before the second pregnancy did not significantly improve VBAC success (64.0% vs 58.4%, P = .67).

CONCLUSION

Increasing pregravid BMI and weight gain between pregnancies reduce VBAC success after a single low transverse cesarean delivery.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Metro Health Medical Center at Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15467571

Citation

Durnwald, Celeste P., et al. "The Impact of Maternal Obesity and Weight Gain On Vaginal Birth After Cesarean Section Success." American Journal of Obstetrics and Gynecology, vol. 191, no. 3, 2004, pp. 954-7.
Durnwald CP, Ehrenberg HM, Mercer BM. The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. Am J Obstet Gynecol. 2004;191(3):954-7.
Durnwald, C. P., Ehrenberg, H. M., & Mercer, B. M. (2004). The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. American Journal of Obstetrics and Gynecology, 191(3), 954-7.
Durnwald CP, Ehrenberg HM, Mercer BM. The Impact of Maternal Obesity and Weight Gain On Vaginal Birth After Cesarean Section Success. Am J Obstet Gynecol. 2004;191(3):954-7. PubMed PMID: 15467571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. AU - Durnwald,Celeste P, AU - Ehrenberg,Hugh M, AU - Mercer,Brian M, PY - 2004/10/7/pubmed PY - 2004/11/9/medline PY - 2004/10/7/entrez SP - 954 EP - 7 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 191 IS - 3 N2 - OBJECTIVE: This study was undertaken to determine the impact of maternal obesity on success of a trial of labor (vaginal birth after cesarean section [VBAC]) after a single low transverse cesarean delivery. STUDY DESIGN: Individual charts of women with low transverse cesarean delivery in their first viable pregnancy who underwent a VBAC in their second viable pregnancy at our urban tertiary care institution were reviewed. Maternal body mass index (BMI) was classified as underweight (<19.8 kg/m2), normal (19.8-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (> or =30 kg/m2). Clinical characteristics and labor outcomes were assessed. Factors potentially affecting VBAC success were analyzed by univariate analysis. Logistic regressions were performed to determine the impact of maternal pregravid BMI on VBAC success after controlling for confounding factors. RESULTS: Of 510 women attempting a trial of labor, 337 (66%) were successful and 173 (34%) failed VBAC. Decreased VBAC success was seen in obese (54.6%) but not overweight (65.5%) women compared with women of normal BMI (70.5%), P = .003 and .36, respectively. Underweight women had more VBAC success than women of normal BMI (84.7% vs 70.5%, P = .04). Controlling for other factors, the association between increasing pregravid BMI and BMI > or =30 kg/m 2 with decreased VBAC success persisted, P = .03 and .006, respectively. Normal BMI women who became overweight before the second pregnancy had decreased VBAC success compared with those whose BMI remained normal (56.6% vs 74.2%, P = .006). However, overweight women who decreased their BMI to normal before the second pregnancy did not significantly improve VBAC success (64.0% vs 58.4%, P = .67). CONCLUSION: Increasing pregravid BMI and weight gain between pregnancies reduce VBAC success after a single low transverse cesarean delivery. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/15467571/The_impact_of_maternal_obesity_and_weight_gain_on_vaginal_birth_after_cesarean_section_success_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002937804005356 DB - PRIME DP - Unbound Medicine ER -