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. 2019 Jul 11;19(1):239.
doi: 10.1186/s12884-019-2393-5.

Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition

Alexander Brenes-Monge  1 , Biani Saavedra-Avendaño  2 , Jacqueline Alcalde-Rabanal  2 , Blair G Darney  3   4
Affiliations

Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition

Alexander Brenes-Monge et al. BMC Pregnancy Childbirth. .

Abstract

Background: In Mexico, obesity is a major public health problem; 71% of adults are overweight or obese. The proportion of deliveries by cesarean is also very high (45%). Women of reproductive age with overweight or obesity may be at higher risk of cesarean.

Methods: We conducted a cross-sectional study to test the association between overweight and obesity (using body mass index, BMI) and cesarean delivery in Mexico using data from the 2012 National Survey of Health and Nutrition (ENSANUT). Our sample included women of reproductive age at the time of survey who reported a live birth between 2006 and 2012. We used bivariate statistics and a multivariate logistic regression model to test the association between measured BMI and self-reported cesarean delivery. We included individual, clinical, and household level confounders and used survey weights to produce population estimates.

Results: Our sample consisted of 4,570 women (population N = 7,447,541). Overall, 44% of the women reported a cesarean at last delivery. We found differences in the proportion of cesarean delivery by BMI group (normal = 39%; 95% CI [35-43]; overweight = 42%; 95% CI [38-45]; obesity = 52%; 95% CI [48-57]; p < 0.001). In multivariable models controlling for socio-demographic and clinical characteristics, we found a strong and independent association between obesity and cesarean delivery among multiparous women, compared with multiparous women with normal BMI (obesity aOR: 1.60; 95% CI [1.21-2.12]).

Conclusions: We provide new evidence about the proportion of women with overweight and obesity who deliver in Mexico. Multiparous women with obesity are at higher risk of cesarean delivery in Mexico than multiparous women with normal body mass index. Given the high prevalence of both obesity and cesarean delivery in Mexico, this relationship is salient for women, health care providers, and the health system. Efforts to reduce the cesarean deliveries rate need to take the obesity epidemic into account.

Keywords: Body mass index; Cesarean delivery; Mode of delivery; Obesity; Overweight; Pregnancy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of analysis sample selection
Fig. 2
Fig. 2
Complications during pregnancy by body mass index, Mexico, 2012
Fig. 3
Fig. 3
Mode of delivery by body mass index, Mexico, 2012
See this image and copyright information in PMC

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