THE PRETERM PREDICTION STUDY: ASSOCIATION OF CAESAREAN DELIVERY WITH INCREASES IN MATERNAL WEIGHT AND BODY MASS INDEX
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Date
2001-11
Authors
NORLIA, HJ. MOHAMAD
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
Objectives: The purpose of this study was to evaluate whether maternal weight
and body mass index measured before or during pregnancy are associated with
an increased risk of caesarean delivery. This study also try to determine whether
greater weight gain during pregnancy is associated with increased risk of
caesarean delivery.
Study design: This is a cross-sectional study conducted in the Obstetrics and
Gynaecology Department, Hospital Universiti Sains Malaysia, Kubang Kerian
Kelantan from 1 st August 1999 till 31 st July 2000. Candidates for this study are
antenatal patient who came for booking and planned to deliver in HUSM with
Singleton pregnancy at period of amenorrhoea of 32 weeks or less and their EDD
must be before 31 st July 2000. During this one year 1359 pregnant women came
for booking. Cases with multiple fetuses, stillbirth, fetal anomalies, selected
medical and surgical complications, and those with incomplete medical record
were excluded. 631 cases remained for analysis. Maternal weight and height
were prospectively recorded. The prepregnancy weight was based on selfreporting
and third trimester weight taken between 27 to 31 week. Both weight and
height were used to calculate the body mass index, and its contribution to the risk
of caesarean delivery was determined.
XXIII
Results: There is an increased in CS rate for prepregnancy maternal weight more
than 79kg, OR=1.744(p=O.001). For third trimester weight more than 79kg, the
odds ratio is 1.227 with p value of 0.002. Prepregnancy 8MI of 26.1-29, the odds
ratio is 1.40B (p=0.08). Patients with prepregnancy BMI more than 29 have higher
CS rate. The odds ratio is 3.042 (p=O.001). Third trimester 8MI of 26.1-29 gives an
odds ratio of 1.291 (p=O.022). For third trimester 8MI more than 29, the odds ratio
is 1.361 (p=O.014). Weight gain within 15.9-18.2kg is also associated with
increased risk of es. The odds ratio is 4.225 (p=O.003). Greater weight
gain(>1B.2kg) gives higher es rate, odds ratio is 4.331 (p=O.01). Univariate
analysis of risk factors for caesarean delivery in 631 eligible women revealed an
increased risk of caesarean section with maternal age less than 20 years and
more than 39 years, OR=3.61 (p=0.027) and OR=2.S82(p=0.00S). Birth weight
more than 4kg is also associated with higher rate of es. It gives odds ratio of
~.OOO (p<O.001). Multivariate stepwise logistic regression analysis confirmed the
association of age, prepregnancy weight, prepregnancy 8MI, weight gain and
baby birth weight as Significance variables contributing to caesarean delivery risk.
Conclusion: The risk of es is associated with age, prepregnancy weight and 8MI,
maternal weight gain and baby birth weight. Prepregnancy counselling about
optimising maternal weight and monitoring weight gain during pregnancy to
decrease risk of es are indicated by this study.
Description
Keywords
Obstetrics and Gynaecology