Sonographic Estimated Fetal Weight and Cesarean Delivery among Nulliparous Women with Obesity

Annie M. Dude; Berkley Davis; Katie Delaney; Lynn M. Yee

doi:10.1055/s-0039-1684035

American Journal of Perinatology Reports, Table of Contents

CC BY-NC-ND 4.0 · AJP Rep 2019; 09(02): e127-e132
DOI: 10.1055/s-0039-1684035

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sonographic Estimated Fetal Weight and Cesarean Delivery among Nulliparous Women with Obesity

Annie M. Dude

¹Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

,

Berkley Davis

²Feinberg School of Medicine, Northwestern University, Chicago, Illinois

,

Katie Delaney

²Feinberg School of Medicine, Northwestern University, Chicago, Illinois

,

Lynn M. Yee

¹Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

› Author Affiliations

Abstract

Objective This study was aimed to examine the association between having an ultrasound estimate of fetal weight (US-EFW) and mode of delivery among obese women.

Study Design A retrospective cohort study of nulliparous women with a body mass index of ≥ 35 kg/m² who delivered term singleton gestations. We examined whether having had an US-EFW within 35 days of delivery, or an US-EFW ≥ 90th percentile for gestational age, was associated with intrapartum cesarean delivery.

Results Of 2,826 women, 22.5% (n = 636) had an US-EFW within 35 days of delivery. Having an US-EFW was associated with increased frequency of cesarean (43.1% for those with an US-EFW versus 30.0% for those without, p < 0.001); this finding persisted when controlling for confounders (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.21–1.81). Of the 636 women with an US-EFW, 22.5% (n = 143) had an US-EFW ≥ 90th percentile for gestational age, which was associated with increased frequency of an intrapartum cesarean (60.8% for those with an US-EFW ≥ 90th percentile vs. 37.9% for those with an US-EFW of < 90th percentile, p < 0.001), even when accounting for confounders (aOR = 1.78, 95% CI: 1.10–2.87).

Conclusion The presence of an US-EFW among nulliparous obese women was associated with undergoing intrapartum cesarean delivery.

Keywords

obesity - pregnancy - ultrasound - cesarean section - large for gestational age

Full Text

References

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