Table 2.
Indications for primary cesarean delivery in nulliparous women.
| Normal weight | Overweight | Obesity class I | Obesity class II | Obesity class III | P-valuea | |
|---|---|---|---|---|---|---|
| Total number of delivery (N=66,502) | 10,765 | 26,635 | 16,988 | 7,270 | 4,844 | NA |
| Total number of primary cesarean delivery (n=19,431) | 1,993 (18.5) | 6,529 (24.5) | 5,482 (32.3) | 2,965 (40.8) | 2,462 (50.8) | NA |
| Indication for primary cesarean delivery, n (%) | NA | |||||
| Failure to progress or cephalopelvic disproportion | 661 (33.2) | 2,714 (41.6) | 2,541 (46.4) | 1,406 (47.4) | 1,203 (48.9) | <.01 |
| Non-reassuring fetal heart tracing | 457 (22.9) | 1,479 (22.7) | 1,161 (21.2) | 629 (21.2) | 540 (21.9) | .11 |
| Malpresentation | 472 (23.7) | 1,121 (17.2) | 801 (14.6) | 357 (12.0) | 225 (9.1) | <.01 |
| Elective | 175 (8.8) | 508 (7.8) | 389 (7.1) | 225 (7.6) | 222 (9.0) | .71 |
| Hypertensive disease | 48 (2.4) | 174 (2.7) | 207 (3.8) | 108 (3.6) | 118 (4.8) | <.01 |
| Multiple gestation | 41 (2.1) | 180 (2.8) | 148 (2.7) | 44 (1.5) | 30 (1.2) | <.01 |
| Placenta previa or vasa previa | 40 (2.0) | 71 (1.1) | 35 (0.6) | 10 (0.3) | 9 (0.4) | <.01 |
| Failed induction | 34 (1.7) | 131 (2.0) | 136 (2.5) | 97 (3.3) | 117 (4.8) | <.01 |
| HIV, active herpes simplex virus lesions | 30 (1.5) | 63 (1.0) | 38 (0.7) | 18 (0.6) | 12 (0.5) | <.01 |
| Uterine scar | 26 (1.3) | 81 (1.2) | 51 (0.9) | 26 (0.9) | 24 (1.0) | .07 |
| Fetal indication or anomaly | 24 (1.2) | 81 (1.2) | 58 (1.1) | 44 (1.5) | 40 (1.6) | .12 |
| Placental abruption | 19 (1.0) | 37 (0.6) | 14 (0.3) | 5 (0.2) | 6 (0.2) | <.01 |
| Chorioamnionitis | 14 (0.7) | 58 (0.9) | 45 (0.8) | 40 (1.4) | 17 (0.7) | .46 |
| Macrosomia | 11 (0.6) | 108 (1.7) | 159 (2.9) | 124 (4.2) | 146 (5.9) | <.01 |
| Failed trial of forceps or vacuum | 3 (0.2) | 21 (0.3) | 14 (0.3) | 7 (0.2) | 3 (0.1) | .36 |
| Grouped Indications, per 100 cesarean delivery | <.01b | |||||
| Clinically indicated | 40.3 | 43.0 | 42.5 | 38.8 | 37.1 | |
| Mixed | 43.6 | 42.0 | 43.0 | 46.2 | 48.3 | |
| Truly electivec | 16.1 | 15.0 | 14.5 | 15.0 | 14.6 |
Abbreviations: NA, not available; HIV, human immunodeficiency virus
a
P-value for percentage per 100 cesarean delivery; calculated by Cochran-Armitage trend test unless otherwise indicated.
b
Chi-square test
c
Elective indications include maternal request, multiparity, women desiring a tubal ligation, advanced maternal age, diabetes mellitus, human papilloma virus, postterm or postdates, pregnancy remote from term, group B streptococcus, polyhydramnios, fetal death, and social or religious concerns.