Table 3.
Indications for primary cesarean delivery in multiparous women.
| Normal weight | Overweight | Obesity class I | Obesity class II | Obesity class III | P-valuea | |
|---|---|---|---|---|---|---|
| Total number of delivery (N=76,961) | 11,164 | 29,362 | 21,019 | 9,473 | 5,943 | NA |
| Total number of primary cesarean delivery (n=7,329) | 719 (6.4) | 2,130 (7.3) | 2,121 (10.1) | 1,257 (13.3) | 1,102 (18.5) | NA |
| Indication for primary cesarean delivery, n (%) | NA | |||||
| Failure to progress or cephalopelvic disproportion | 104 (14.5) | 433 (20.3) | 484 (22.8) | 342 (27.2) | 279 (25.3) | <.01 |
| Non-reassuring fetal heart tracing | 169 (23.5) | 493 (23.2) | 501 (23.6) | 286 (22.8) | 262 (23.8) | 0.93 |
| Malpresentation | 256 (35.6) | 651 (30.6) | 563 (26.5) | 305 (24.3) | 252 (22.9) | <.01 |
| Elective | 29 (4.0) | 126 (5.9) | 119 (5.6) | 89 (7.1) | 84 (7.6) | <.01 |
| Hypertensive disease | 13 (1.8) | 30 (1.4) | 63 (3.0) | 46 (3.7) | 38 (0.4) | <.01 |
| Multiple gestation | 12 (1.7) | 115 (5.4) | 110 (5.2) | 61 (4.9) | 38 (3.5) | .89 |
| Placenta previa or vasa previa | 38 (5.3) | 101 (4.7) | 58 (2.7) | 20 (1.6) | 11 (1.0) | <.01 |
| Failed induction | 2 (0.3) | 10 (0.5) | 14 (0.7) | 12 (1.0) | 25 (2.3) | <.01 |
| HIV, active herpes simplex virus lesions | 15 (2.1) | 48 (2.3) | 41 (1.9) | 17 (1.4) | 11 (1.0) | <.01 |
| Uterine scar | 11 (1.5) | 35 (1.6) | 34 (1.6) | 16 (1.3) | 10 (0.9) | 0.12 |
| Fetal indication or anomaly | 9 (1.3) | 38 (1.8) | 41 (1.9) | 31 (2.5) | 24 (2.2) | 0.08 |
| Placental abruption | 21 (2.9) | 32 (1.5) | 27 (1.3) | 12 (1.0) | 4 (0.4) | <.01 |
| Chorioamnionitis | 1 (0.1) | 6 (0.3) | 8 (0.4) | 5 (0.4) | 2 (0.2) | 0.82 |
| Macrosomia | 5 (0.7) | 36 (1.7) | 87 (4.1) | 64 (5.1) | 92 (8.4) | <.01 |
| Failed trial of forceps or vacuum | 2 (0.3) | 6 (0.3) | 3 (0.1) | 2 (0.2) | 1 (0.1) | .20 |
| Grouped Indications, percentage | .75b | |||||
| Clinically indicated | 38.8 | 40.8 | 39.7 | 40.8 | 37.5 | |
| Mixed | 44.9 | 44.1 | 44.0 | 43.6 | 46.3 | |
| Truly electivec | 16.3 | 15.1 | 16.4 | 15.6 | 16.2 |
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.