Sonographic Estimated Fetal Weight and Cesarean Delivery among Nulliparous Women with ObesityFunding Author L.M.Y. is supported by the NICHD K12 HD050121–11. Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
19 November 2018
21 February 2019
09 April 2019 (online)
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.
A version of this paper was presented at the Society for Reproductive Investigation 65th Annual Scientific Meeting, March 6–10, 2018, San Diego, CA.
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