Dataset Information

Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (The MUM SIZE Study).

ABSTRACT:

Objectives

To investigate associations between maternal body mass index (BMI) at delivery (using pregnancy-specific BMI cut-off values 5?kg/m² higher in each of the WHO groups) and clinical, theatre utilisation and health economic outcomes for women undergoing caesarean section (CS).

Design

A prospective multicentre observational study.

Setting

Seven secondary or tertiary referral obstetric hospitals.

Participants

One thousand and four hundred and fifty-seven women undergoing all categories of CS.

Data collection

Height and weight were recorded at the initial antenatal visit and at delivery. We analysed the associations between delivery BMI (continuous and pregnancy-specific cut-off values) and total theatre time, surgical time, anaesthesia time, maternal and neonatal adverse outcomes, total hospital admission and theatre costs.

Results

Mean participant characteristics were: age 32 years, gestation at delivery 38.4 weeks and delivery BMI 32.2?kg/m². Fifty-five per cent of participants were overweight, obese or super-obese using delivery pregnancy-specific BMI cut-off values. As BMI increased, total theatre time, surgical time and anaesthesia time increased. Super-obese participants had approximately 27% (17 min, p<0.001) longer total theatre time, 20% (9 min, p<0.001), longer surgical time and 40% (11 min, p<0.001) longer anaesthesia time when compared with normal BMI participants. Increased BMI at delivery was associated with increased risk of maternal intensive care unit admission (relative risk 1.07, p=0.045), but no increased risk of neonatal admission to higher acuity care. Total hospital admission costs were 15% higher in super-obese women compared with normal BMI women and theatre costs were 27% higher in super-obese women.

Conclusions

Increased maternal BMI was associated with increased total theatre time, surgical and anaesthesia time, increased total hospital admission costs and theatre costs. Clinicians and health administrators should consider these clinical risks, time implications and financial costs when managing pregnant women.

SUBMITTER: Dennis AT

PROVIDER: S-EPMC5734348 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (The MUM SIZE Study).

Dennis Alicia Therese AT Lamb Karen Elaine KE Story David D Tew Michelle M Dalziel Kim K Clarke Philip P Lew Jospeh J Parker Anna A Hessian Elizabeth E Teale Gyln G Simmons Scott S Casalaz Dan D

BMJ open 20170630 6

<h4>Objectives</h4>To investigate associations between maternal body mass index (BMI) at delivery (using pregnancy-specific BMI cut-off values 5 kg/m<sup>2</sup> higher in each of the WHO groups) and clinical, theatre utilisation and health economic outcomes for women undergoing caesarean section (CS).<h4>Design</h4>A prospective multicentre observational study.<h4>Setting</h4>Seven secondary or tertiary referral obstetric hospitals.<h4>Participants</h4>One thousand and four hundred and fifty-se ...[more]

PMID: 28667219

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Project description:To provide an update on economic related inequalities in caesarean section rates within countries.Secondary analysis of demographic and health surveys and multiple indicator cluster surveys.72 low and middle income countries with a survey conducted between 2010 and 2014 for analysis of the latest situation of inequality, and 28 countries with a survey also conducted between 2000 and 2004 for analysis of the change in inequality over time.Women aged 15-49 years with a live birth during the two or three years preceding the survey.Data on caesarean section were disaggregated by asset based household wealth status and presented separately for five subgroups, ranging from the poorest to the richest fifth. Absolute and relative inequalities were measured using difference and ratio measures. The pace of change in the poorest and richest fifths was compared using a measure of excess change.National caesarean section rates ranged from 0.6% in South Sudan to 58.9% in the Dominican Republic. Within countries, caesarean section rates were lowest in the poorest fifth (median 3.7%) and highest in the richest fifth (median 18.4%). 18 out of 72 study countries reported a difference of 20 percentage points or higher between the richest and poorest fifth. The highest caesarean section rates and greatest levels of absolute inequality were observed in countries from the region of the Americas, whereas countries from the African region had low levels of caesarean use and comparatively lower levels of absolute inequality, although relative inequality was quite high in some countries. 26 out of 28 countries reported increases in caesarean section rates over time. Rates tended to increase faster in the richest fifth (median 0.9 percentage points per year) compared with the poorest fifth (median 0.2 percentage points per year), indicating an increase in inequality over time in most of these countries.Substantial within country economic inequalities in caesarean deliveries remain. These inequalities might be due to a combination of inadequate access to emergency obstetric care among the poorest subgroups and high levels of caesarean use without medical indication in the richest subgroups, especially in middle income countries. Country specific strategies should address these inequalities to improve maternal and newborn health.

Dataset Information

Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (The MUM SIZE Study).

Objectives

Design

Setting

Participants

Data collection

Results

Conclusions

Publications

Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (The MUM SIZE Study).

Similar Datasets

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