TABLE 5.
Mode of delivery comparison among obesity groupsa
| Variable | Morbid vs obese
|
Super vs obese
|
Super vs morbid
|
|||
|---|---|---|---|---|---|---|
| Adjusted relative riskb (95% CI) | P value | Adjusted relative riskb (95% CI) | P value | Adjusted relative riskb (95% CI) | P value | |
| Nulliparous pregnancy | ||||||
|
| ||||||
| Vaginal delivery | 0.69 (0.64–0.75) | < .0001 | 0.40 (0.31–0.51) | < .0001 | 0.58 (0.45–0.75) | < .0001 |
|
| ||||||
| Operative vaginal delivery | 0.88 (0.77–1.01) | .06 | 0.81 (0.53–1.23) | .32 | 0.92 (0.59–1.42) | .69 |
|
| ||||||
| Primary scheduled cesarean delivery | 1.31 (1.19–1.45) | < .0001 | 2.41 (1.88–3.09) | < .0001 | 1.85 (1.43–2.40) | < .0001 |
|
| ||||||
| Primary emergency cesarean delivery | 1.42 (1.30–1.56) | < .0001 | 1.59 (1.22–2.07) | .001 | 1.09 (0.83–1.44) | .53 |
|
| ||||||
| Multiparous pregnancy | ||||||
|
| ||||||
| Vaginal delivery | 0.66 (0.62–0.69) | < .0001 | 0.52 (0.45–0.60) | < .0001 | 0.79 (0.68–0.91) | .001 |
|
| ||||||
| Operative vaginal delivery | 1.06 (0.93–1.21) | .41 | 1.25 (0.90–1.73) | .19 | 1.17 (0.83–1.65) | .38 |
|
| ||||||
| Vaginal birth after cesarean delivery | 1.05 (0.88–1.26) | .57 | 1.19 (0.76–1.84) | .45 | 1.08 (0.68–1.73) | .73 |
|
| ||||||
| Primary scheduled cesarean delivery | 1.24 (1.09–1.40) | .001 | 1.42 (1.05–1.93) | .02 | 1.18 (0.86–1.63) | .30 |
|
| ||||||
| Primary emergency cesarean delivery | 1.19 (1.05–1.35) | .01 | 1.35 (1.00–1.83) | .048 | 1.13 (0.83–1.56) | .44 |
|
| ||||||
| Repeat scheduled cesarean delivery | 1.52 (1.43–1.61) | < .0001 | 1.80 (1.56–2.07) | < .0001 | 1.19 (1.02–1.38) | .03 |
|
| ||||||
| Totals | ||||||
|
| ||||||
| Vaginal delivery | 0.67 (0.64–0.70) | .0001 | 0.50 (0.44–0.56) | < .0001 | 0.75 (0.66–0.84) | < .0001 |
|
| ||||||
| Operative vaginal | 0.95 (0.87–1.04) | .28 | 0.97 (0.75–1.25) | .81 | 1.01 (0.77–1.32) | .94 |
|
| ||||||
| Cesarean delivery | 1.42 (1.32–1.53) | < .0001 | 1.82 (1.48–2.22) | < .0001 | 1.27 (1.03–1.56) | .02 |
|
| ||||||
| Primary scheduled cesarean delivery | 1.23 (1.14–1.32) | < .0001 | 1.66 (1.39–1.98) | < .0001 | 1.37 (1.14–1.66) | .001 |
|
| ||||||
| Primary emergency cesarean delivery | 1.26 (1.18–1.36) | < .0001 | 1.28 (1.06–1.55) | .01 | 0.99 (0.81–1.21) | .93 |
a
Example: women who were morbidly obese were 1.31 times more likely to deliver by primary scheduled cesarean delivery than were women who were obese;
b
Adjusted for smoking, insurance status, race/ethnicity, maternal age, education, prenatal care, and marital status.
Marshall. Maternal superobesity and perinatal outcomes. Am J Obstet Gynecol 2012.