Prepregnancy Body Mass Index, Gestational Weight Gain, and Odds of Cesarean Delivery in Hispanic Women

OBJECTIVE: To evaluate the association between prepregnancy body mass index (BMI), gestational weight gain (GWG), and cesarean delivery in Hispanics. METHODS: We examined these associations among 1,215 participants in Proyecto Buena Salud, a prospective cohort conducted from 2006–2011 among Hispanic women. Prepregnancy BMI, GWG, and mode of delivery were abstracted from medical records. RESULTS: A quarter of participants entered pregnancy with obesity, 23% delivered via cesarean, and 52% exceeded Institute of Medicine guidelines for GWG. After adjusting for age, women who were obese had 2.03 times the odds of cesarean delivery compared to women with normal BMI (95% confidence interval [CI] 1.46–2.82); findings remained significant after adjusting for GWG. Women with excessive total GWG had 1.49 times the odds of cesarean delivery (95% CI 1.06–2.10) compared to women who gained within guidelines. Excessive rate of 3(rd) trimester GWG (standard deviation [SD] change in GWG/week) increased odds of cesarean delivery (OR=1.66, 95% CI 1.05–2.62), while excessive rate of 1(st) and 2(nd) trimester GWG were not associated with increased odds. CONCLUSIONS: Obesity prior to pregnancy was associated with an increased odds of cesarean delivery among Hispanics. Excessive GWG across pregnancy and excessive rate of 3(rd) trimester GWG were also associated with increased odds.