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Am J Perinatol 2024; 41(07): 909-914
DOI: 10.1055/a-1788-4900
Original Article

The Relationship between Body Mass Index and Operative Complications in Patients undergoing Immediate Postpartum Tubal Ligation

Jewel A. Brown
1   Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida
2   Tampa General Circle, STC, Tampa, Florida
3   Department of Obstetrics and Gynecology, University of California Davis Health, Sacramento, California
,
Mallorie L. Huff
1   Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida
,
Bianca L. Arboleda
1   Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida
4   Department of Obstetrics and Gynecology, University of Kentucky, Lexington, Kentucky
,
Judette M. Louis
1   Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida
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Abstract

Objective The objective of this study is to examine the relationship between body mass index (BMI) and complications for patients undergoing postpartum permanent contraception.

Study Design Retrospective cohort study of patients aged 18 or older who had a vaginal delivery at an academic hospital between 2011 and 2016 and underwent a postpartum tubal ligation during the delivery admission. There were three comparative groups: nonobese (BMI ≤ 29 kg/m2), obese (BMI 30–39 kg/m2), and morbidly obese BMI (≥40 kg/m2). The outcome of interest was composite operative complications which included any occurrence of an intraoperative, postoperative, or anesthesia complication.

Results A total of 921 patients were included for analysis. Average operative time was statistically longer for patients in the morbidly obese group (33 minutes) vs. the nonobese (25 minutes) and obese (29 minutes) groups (p < 0.0001). Composite complications were greater for the obese groups, but not statistically significant (5.1 vs. 6 vs. 16%, p = 0.06). Wound complications were significantly greater for the obese groups (0.8 vs. 1.5 vs. 5.5%, p = 0.01). A logistic regression model demonstrated that only operative time was predictive of operative complications.

Conclusion Overall complications of postpartum tubal complications are low; however, our study did demonstrate significantly longer operative time and wound complications for patients with obesity. The findings of our study indicate that postpartum permanent contraception can remain as an option for these patients. Further studies may help identify the best practices to decrease operative time and subsequent wound complications. This study contributes to the limited data regarding obesity and postpartum permanent contraception. We found increased operative time and wound complications for obese patients. Additional studies may identity best practices to decrease these complications. Given our findings of overall low operative complications, postpartum permanent contraception can remain an option for obese patients.

Keywords

obesity - postpartum permanent contraception - tubal ligation - surgical complications


Publication History

Received: 15 November 2021

Accepted: 17 February 2022

Accepted Manuscript online:
04 March 2022

Article published online:
06 May 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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