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OBJECTIVE: Maternal obesity is a well-known risk factor for caesarean delivery. The aim of this study is to determine whether all the spectrum of pre-pregnancy maternal corpulence (body mass index BMI) is associated with the risk of caesarean delivery. DESIGN: Observational study over 4.5 years (2001-05). SETTING: Groupe Hospitalier Sud-Réunion's maternity (island of La Réunion, French overseas department, Indian Ocean). POPULATION: All consecutive singleton live births having delivered at the maternity. METHODS: Data have been analysed according to different risk factors. Maternal corpulence has been defined as the maternal pre-pregnancy weight. BMIs have been studied by multiples of 5 kg/m2 from 10-14.9 kg/m2 to 40-44.9 kg/m2. MAIN OUTCOME MEASURE: Rate of caesarean section. RESULTS: There were 17 462 singleton live births during the period, of which 16 952 (97.1% of the total) pre-pregnancy BMIs have been determined. There is a linear association (chi 2 for linear trend, P or =37 weeks), very short maternal height ( or = 35 years (adjusted chi 2, P < 0.001). CONCLUSION: There is a significant linear association between pre-pregnancy maternal corpulence and risk of caesarean deliveries in pregnancies at term. The authors discuss several interpretations including the adaptability of fetal birthweights to maternal corpulence and the concept of soft-tissue dystocia.
Barau et al. (Wed,) studied this question.