Planned caesarean section linked to lower risk in pregnant women living with obesity

A new study has found that planned non-labour caesarean section (NLCS) is associated with a reduced risk of complications in pregnant women living with obesity compared to spontaneous labour.

The large population-based retrospective cohort study, published in the International Journal of Obesity, analysed data from 27,472 first-time mothers living with obesity who had uncomplicated, full-term, single-baby pregnancies between 2012 and 2019.

Researchers examined the risks associated with different planned modes of delivery, including waiting for spontaneous labour, planned induction of labour, and planned NLCS, which refers to an elective caesarean section before the onset of labour.

The study used the Adverse Outcome Index (AOI), a composite measure of 10 maternal and neonatal complications. It found that planned NLCS was associated with a significant reduction in risk across all categories:

• 41 per cent lower overall AOI risk compared to spontaneous labour

• 54 per cent lower maternal-specific AOI risk

• 30 per cent lower neonatal-specific AOI risk

Meanwhile, there was no significant difference in overall AOI risk when comparing planned induction of labour to spontaneous labour.

The findings suggest that NLCS may be a safer option for some women living with obesity, reducing the likelihood of complications for both mother and baby. However, the authors stress that further research is needed to understand the long-term impact of NLCS, particularly in relation to severe outcomes.

“Shared decision-making between patient and practitioner remains essential in ensuring quality obstetrical care,” the researchers concluded.