Dataset Information

Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review.

ABSTRACT:

Aim

To describe the relationship between cesarean skin incision type and postoperative wound complications (WCs) in obese pregnant patients.

Materials & methods

MEDLINE (PubMed and OVID), Embase, Scopus, Web of Science Core Collection, Cochrane Library and ClinicalTrials.gov databases were used for publication search. Selection criteria consisted of articles studying pregnant patients with BMI ?30 kg/m² undergoing cesarean delivery and assessing the effect of skin incision type on postoperative maternal outcomes.

Results

Ten publications met criteria for a systematic review of a total of 2946 patients. The transverse skin incision was associated with a lower rate of WC compared with the vertical skin incision. The pooled risk ratio for WCs was 0.47 (95% CI: 0.37-0.58; p < 0.00001).

Conclusion

Transverse skin incision may be preferable to vertical skin incision at cesarean delivery in pregnant patients with obesity as it may be associated with a lower rate of WCs.PROSPERO registration ID: CRD42020151106.

SUBMITTER: Zoorob D

PROVIDER: S-EPMC7850001 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review.

Zoorob Dani D Zarudskaya Oxana O Van Hook James J Moussa Hind N HN

Future science OA 20201218 3

<h4>Aim</h4>To describe the relationship between cesarean skin incision type and postoperative wound complications (WCs) in obese pregnant patients.<h4>Materials & methods</h4>MEDLINE (PubMed and OVID), Embase, Scopus, Web of Science Core Collection, Cochrane Library and ClinicalTrials.gov databases were used for publication search. Selection criteria consisted of articles studying pregnant patients with BMI ≥30 kg/m<sup>2</sup> undergoing cesarean delivery and assessing the effect of skin incis ...[more]

PMID: 33552545

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Project description:BackgroundSevere maternal morbidity - life-threatening childbirth complications - has more than doubled in the United States over the past 15?years, affecting more than 50,000 women (1.4% of deliveries) annually. During this time period, maternal age, obesity, comorbidities, and cesarean delivery also increased and may be related to the rise in severe maternal morbidity. We sought to evaluate: (1) the association of advanced maternal age, pre-pregnancy obesity, pre-pregnancy comorbidities, and cesarean delivery with severe maternal morbidity, and (2) whether changes in the prevalence of these risk factors affected the trend of severe maternal morbidity.MethodsThis population-based cohort study used linked birth record and patient discharge data from live births in California during 2007-2014 (n?=?3,556,206). We used multivariable logistic regression models to assess the association of advanced maternal age (?35?years), pre-pregnancy obesity (body mass index ?30?kg/m2), pre-pregnancy comorbidity (index of 12 conditions), and cesarean delivery with severe maternal morbidity prevalence and trends. Severe maternal morbidity was identified by an index of 18 diagnosis and procedure indicators. We estimated odds ratios, predicted prevalence, and population attributable risk percentages.ResultsThe prevalence of severe maternal morbidity increased by 65% during 2007-2014. Advanced maternal age, pre-pregnancy obesity, and pre-pregnancy comorbidity also increased during this period, but cesarean delivery did not. None of these risk factors affected the increasing trend of severe maternal morbidity. However, the pre-pregnancy risk factors together were estimated to contribute to 13% (95% confidence interval: 12, 14%) of severe maternal morbidity cases in the study population overall, and cesarean delivery was estimated to contribute to 37% (95% confidence interval: 36, 38%) of cases.ConclusionsPre-pregnancy health and cesarean delivery are important risk factors for severe maternal morbidity but do not explain an increasing trend of severe maternal morbidity in California during 2007-2014. Investigation of other potential contributors is needed in order to identify ways to reverse the trend of severe maternal morbidity.

Dataset Information

Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review.

Aim

Materials & methods

Results

Conclusion

Publications

Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review.

Similar Datasets

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