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Does maternal obesity explain trends in caesarean section rates? Evidence from a large Irish maternity hospital

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Abstract

Background

A feature of contemporary obstetrics in wealthy countries has been both the continuing increase in caesarean section (CS) rates and the emergence of high levels of maternal obesity.

Aims

The purpose of this study was to examine whether the increasing CS rate in a large university maternity hospital was attributable in part to maternal obesity.

Methods

We studied all women who delivered a baby weighing ≥ 500 g from 2009 to 2014 in one of the largest maternity hospitals in Europe. Logistic regression techniques were employed to examine the contribution of trends in maternal BMI on the prevalence of CS.

Results

Obese women were more likely to be delivered by CS in 2014 than in 2009. Multivariate analysis shows that the increase in CS rates could not be explained by changes in obesity levels in either nulliparas or multiparas. The increase in CS rates during the 6 years was strongly associated with advancing maternal age, particularly for nulliparas.

Conclusions

The study found that although the prevalence of being overweight or obese changed little over the period, the odds of having a CS if a woman is obese have increased for multiparas. For nulliparas, increasing CS rates were found to be strongly associated with an increase in maternal age over the period which is important because of the evidence that Irish women are choosing to defer having their first baby until later in life.

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Abbreviations

CS :

Caesarean section BMI Body Mass Index GDM Gestational Diabetes Mellitus

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Acknowledgements

The authors gratefully acknowledge the assistance of the staff of the IT Department in the Coombe Women and Infants University Hospital for making available the data used in this paper.

Funding

This work was funded by the Health Research Board (grant number HRA_HSR/2012/8). The study sponsor had no role in study design, analysis and interpretation of the data, in the writing of the report, and in the submission of the paper for publication.

Author information

Authors and Affiliations

  1. Social Division, Economic and Social Research Institute,, Whitaker Square, Sir John Rogerson’s Quay, Dublin 2, Ireland

    Aoife Brick

  2. Department of Sociology, Trinity College Dublin, Dublin 2, Ireland

    Richard Layte

  3. UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 2, Ireland

    Aoife McKeating & Michael J. Turner

  4. Coombe Women and Infants University Hospital, Cork Street, Dublin 2, Ireland

    Sharon R. Sheehan

Authors
  1. Aoife Brick
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  2. Richard Layte
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  3. Aoife McKeating
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  4. Sharon R. Sheehan
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  5. Michael J. Turner
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Corresponding author

Correspondence to Aoife Brick.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

Ethical approval for this study was obtained from the Coombe Women and Infants University Hospital Ethics Committee upon submission of a written application. As the study involved collection of anonymised data, patient consent was not required following Committee review.

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Brick, A., Layte, R., McKeating, A. et al. Does maternal obesity explain trends in caesarean section rates? Evidence from a large Irish maternity hospital. Ir J Med Sci 189, 571–579 (2020). https://doi.org/10.1007/s11845-019-02095-4

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  • DOI: https://doi.org/10.1007/s11845-019-02095-4

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