Abstract
AimTo evaluate maternal, neonatal and anesthetic outcomes according to BMI in women undergoing cesarean section.BackgroundIncreased incidence rates of obesity and morbid obesity have been reported in the United States. Pregnant obese patients are at increased risk of maternal and fetal complications, and obstetric and anesthetic management of these patients is especially challenging.MethodsA retrospective chart review of patients who underwent cesarean section in a single center between 2015 and 2016 was conducted. Anesthetic, obstetric and neonatal outcomes were analyzed in relation to levels of BMI.ResultsSeven hundred and seventy one patients underwent cesarean section during the study period. The number of patients with normal BMI, obesity and morbid obesity was 213 (27.6%), 365 (47.3%) and 193 (25%), respectively. Sixty-one percent of the patients in morbidly obese group had at least one comorbidity (p < 0.01). We found no significant differences with respect to perioperative obstetric complications. Intraoperative blood loss was significantly higher in the morbidly obese group.ConclusionIncreasing BMI is associated with comorbidities such as hypertension and diabetes mellitus, and with increased intraoperative blood loss. We were unable to detect differences in other obstetric, anesthetic and neonatal outcomes.
Highlights
Obesity is a significant public health problem with increasing incidence in both the developed and the developing world
The morbidly obese patients had the highest proportion of African American ethnicity (66%), p < 0.001
This study shows that at our institution we have a significant prevalence of obesity and morbid obesity in patients undergoing cesarean section
Summary
Obesity is a significant public health problem with increasing incidence in both the developed and the developing world. Data from the Behavioral Risk Factor Surveillance System revealed that morbid obesity, defined as the presence of a BMI > 40 kg/ m2 [3], doubled between 1986 and 2000 [4]. Obese individuals are at high risk for the coexistence of several comorbid conditions that affect different organ systems. Risk of developing coronary artery disease is increased by 50% and likelihood of developing atrial fibrillation is significantly higher in morbidly obese patients [5]. Other complications associated with morbid obesity include obstructive sleep apnea, gastroesophageal reflux and cerebrovascular disease [7,8,9]
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