When women who have diabetes or are overweight become pregnant, they have an increased likelihood of having to undergo a cesarean delivery, according to a new report.

Dr. Hugh M. Ehrenberg and colleagues from Case Western Reserve University School of Medicine in Cleveland, Ohio, examined the influence of obesity and diabetes before pregnancy on the rate of cesareans among some 12,300 women for whom complete records were available.

Cesarean delivery was nearly twice as common among obese women (14 percent) compared with normal-weight women (8 percent), the team reports in the American Journal of Obstetrics and Gynecology. C-section rates were also significantly higher in overweight women (10 percent).

The rates of cesarean delivery were also higher in women who had insulin-treated diabetes before they became pregnant (25 percent), the report indicates.

The chances of cesarean delivery rose with increasing body weight, the investigators report, whereas the higher risk of cesarean delivery associated with diabetes remained relatively constant as weight increased.

"With the relative prevalence of obesity and diabetes in our population and the rising rate of obesity among (pregnant) women, obesity exerts a more significant influence on the risk of cesarean delivery overall," the authors write.

They say their findings have "important implications" for counseling overweight and obese women before they become pregnant.

SOURCE: American Journal of Obstetrics and Gynecology, September 2004.

Reference Source 89
October 28, 2004

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