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, Biani Saavedra-Avendaño, Jacqueline Alcalde-Rabanal, Blair Darney

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article number239
JournalBMC Pregnancy and Childbirth
Volume19
Issue number1
DOIs
StatePublished - Jul 11 2019

Fingerprint

Nutrition Surveys
Mexico
Health Surveys
Obesity
Cross-Sectional Studies
Body Mass Index
Logistic Models
Live Birth
Women's Health
Health Personnel
Population
Public Health
Demography
Weights and Measures

Keywords

  • Body mass index
  • Cesarean delivery
  • Mode of delivery
  • Obesity
  • Overweight
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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. / Brenes-Monge, Alexander; Saavedra-Avendaño, Biani; Alcalde-Rabanal, Jacqueline; Darney, Blair.

In: BMC Pregnancy and Childbirth, Vol. 19, No. 1, 239, 11.07.2019.

Research output: Contribution to journalArticle

@article{14a8855a011e43f2b9e635f5586c2cdd,
title = "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",
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",
author = "Alexander Brenes-Monge and Biani Saavedra-Avenda{\~n}o and Jacqueline Alcalde-Rabanal and Blair Darney",
year = "2019",
month = "7",
day = "11",
doi = "10.1186/s12884-019-2393-5",
language = "English (US)",
volume = "19",
journal = "BMC Pregnancy and Childbirth",
issn = "1471-2393",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - 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

AU - Brenes-Monge, Alexander

AU - Saavedra-Avendaño, Biani

AU - Alcalde-Rabanal, Jacqueline

AU - Darney, Blair

PY - 2019/7/11

Y1 - 2019/7/11

N2 - 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.

AB - 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.

KW - Body mass index

KW - Cesarean delivery

KW - Mode of delivery

KW - Obesity

KW - Overweight

KW - Pregnancy

UR - http://www.scopus.com/inward/record.url?scp=85069482392&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069482392&partnerID=8YFLogxK

U2 - 10.1186/s12884-019-2393-5

DO - 10.1186/s12884-019-2393-5

M3 - Article

C2 - 31296185

AN - SCOPUS:85069482392

VL - 19

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

SN - 1471-2393

IS - 1

M1 - 239

ER -