Excess Maternal Weight Gain in Pregnancy and its Relationship to Operative Delivery

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Rivard, Lauren B.
Pregnancy , Weight Gain , Operative Delivery , Cesarean Section
Increasing obesity rates in Canadian women are at an all time high with more than 50% of Canadian women falling into one of the four overweight to obese categories. Further to this 11-21% of Canadian women who are of child-bearing age are being described as overweight or obese. Along with the increasing rates of obesity is an increase in the number of operative deliveries experienced by pregnant women in Canada. Canadian women experience cesarean section (CS) approximately 21% of the time while women in Ontario experience an even higher rate of CS (26%). While currently there are several studies examining the relationship between pre-pregnancy overweight and obesity and its association with CS, there is little research examining the relationship between excess weight gain in pregnancy and operative delivery methods. Data were collected through a retrospective chart review to examine the relationship between excess weight gain in pregnancy and operative delivery methods. Mean weight gain throughout pregnancy was measured. Data analysis was conducted using t-tests, Chi-Squared analyses and Fisher’s Exact test of significance, accepting a significance level of alpha = 0.05 with a 95% Confidence Interval of difference. The analysis conducted demonstrated no significant relationship between weight gain in pregnancy and operative delivery methods. When examining maternal weight and labour type, statistical significance was reached (p = 0.04) demonstrating increased likelihood of induction with excess weight gain in pregnancy; statistical significance was also reached with maternal age greater than 35 years and increased risk for operative delivery(p = 0.04). Further analysis demonstrated statistically significant results when examining one minute Apgar scores between the group of women with recorded weights in comparison to those women whose charts did not contain weights. The lack of findings in this study may be largely attributed to the small sample size.Important practice issues were identified. It is important that pre-pregnancy or early pregnancy weight and height be recorded on all women in hospital databases as well paper charts. Consistency in recording weight units in either pounds or kilograms is imperative. Dietary consultation is an important component of prenatal care and women who enter pregnancy overweight or obese should have immediate access to nutritional counseling.
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