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Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (the MUM SIZE study)

Dennis, Alicia Therese, Lamb, Karen Elaine, Story, David, Tew, Michelle, Dalziel, Kim, Clarke, Philip, Lew, Jospeh, Parker, Anna, Hessian, Elizabeth, Teale, Gyln, Simmons, Scott and Casalaz, Dan 2017, Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (the MUM SIZE study), BMJ open, vol. 7, no. 6, pp. 1-9, doi: 10.1136/bmjopen-2016-015630.

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Title Associations between maternal size and health outcomes for women undergoing caesarean section: a multicentre prospective observational study (the MUM SIZE study)
Author(s) Dennis, Alicia Therese
Lamb, Karen ElaineORCID iD for Lamb, Karen Elaine orcid.org/0000-0001-9782-8450
Story, David
Tew, Michelle
Dalziel, Kim
Clarke, Philip
Lew, Jospeh
Parker, Anna
Hessian, Elizabeth
Teale, Gyln
Simmons, Scott
Casalaz, Dan
Journal name BMJ open
Volume number 7
Issue number 6
Article ID e015630
Start page 1
End page 9
Total pages 9
Publisher BMJ Open
Place of publication London, Eng.
Publication date 2017-06-01
ISSN 2044-6055
Keyword(s) maternal body mass index
BMI
caesarean section (SC)
theatre utilisation
health economic outcomes
Summary Objectives To investigate associations between maternal body mass index (BMI) at delivery (using pregnancy-specific BMI cut-off values 5 kg/m 2 higher in each of the WHO groups) and clinical, theatre utilisation and health economic outcomes for women undergoing caesarean section (CS).

Design
A prospective multicentre observational study. Setting Seven secondary or tertiary referral obstetric hospitals.

Participants
One thousand and four hundred and fifty-seven women undergoing all categories of CS.

Data collection Height and weight were recorded at the initial antenatal visit and at delivery. We analysed the associations between delivery BMI (continuous and pregnancy-specific cut-off values) and total theatre time, surgical time, anaesthesia time, maternal and neonatal adverse outcomes, total hospital admission and theatre costs.

Results Mean participant characteristics were: age 32 years, gestation at delivery 38.4 weeks and delivery BMI 32.2 kg/m 2. Fifty-five per cent of participants were overweight, obese or super-obese using delivery pregnancy-specific BMI cut-off values. As BMI increased, total theatre time, surgical time and anaesthesia time increased. Super-obese participants had approximately 27% (17 min, p < 0.001) longer total theatre time, 20% (9 min, p < 0.001), longer surgical time and 40% (11 min, p < 0.001) longer anaesthesia time when compared with normal BMI participants. Increased BMI at delivery was associated with increased risk of maternal intensive care unit admission (relative risk 1.07, p=0.045), but no increased risk of neonatal admission to higher acuity care. Total hospital admission costs were 15% higher in super-obese women compared with normal BMI women and theatre costs were 27% higher in super-obese women.

Conclusions Increased maternal BMI was associated with increased total theatre time, surgical and anaesthesia time, increased total hospital admission costs and theatre costs. Clinicians and health administrators should consider these clinical risks, time implications and financial costs when managing pregnant women.
Language eng
DOI 10.1136/bmjopen-2016-015630
Field of Research 111402 Obstetrics and Gynaecology
Socio Economic Objective 920507 Women's Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30101666

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.