Objectives

This study examined absolute and proportional gestational weight gain and prepregnancy body mass index as predictors of primary cesarean delivery.

Methods

Data were derived form a prospective study of pregnancy outcome risk factors in 2301 women in greater New Haven, Conn, who had singleton deliveries by primary cesarean (n=312) or vaginal delivery (n=1989) and for whom height, prepregnancy weight, and weight gain were available.

Women were divided into 4 body mass index groups (under-weight, low average, high average, and obese) and further subdivided into 8 groups according to median proportional or absolute weight gain.

Results

Risk of cesarean delivey increased with increasing body mass index and gestational weight ghain greater than the median for one's body mass index.

Proportional weight gain was more predictive of cesarean delivery than absolute weight gain ?

Under-weight women gaining more than 27.8% of their prepregnancy weight had a 2-fold adjusted relative risk of cesarean delivery.

Conclusions

Proportional weight gain is an important predictor of cesarean delivery for underweight women ; high body mass index is also predictive of increased risk.