In addition to general health risks, obesity may have an additional associated risk-extremely obese women may be more likely to give birth by Cesarean section. A recent study conducted by Medical Center researchers points to a correlation between morbid obesity in pregnant women and the chance that they will have C-sections.
The study examined medical records of about 2,500 expectant mothers from across the state whose weight was measured during a 16-month period. The researchers discovered that one third of the women delivered by C-sections.
The average Body Mass Index-which establishes a scale of obesity based on height and weight-for those who had vaginal deliveries was 31; for those who had C-sections it was 53.
Putting the findings in perspective, a 5'4" tall person weighing 175 pounds would have a BMI of 30. According to national consensus, people with a BMI of over 30 are considered obese; those with a BMI of over 35 are morbidly obese.
The exact reasons for the correlation between obesity and C-section delivery are not clear, though.
Dr. Andrew Harris, chief of obstetric anesthesia at Johns Hopkins University, suggested that the increased likelihood may be caused by fatty tissue in the birth canal or because obese women tend to have larger babies.
C-section deliveries carry extra problems for overweight women, particularly in the administration of anesthesia.
"The problem here is that soft tissue swells up during pregnancy," Bell said. "Since fat contains lots of soft tissue, breathing passages can become hindered in obese women."
In such cases, anesthesiologists use a method of anesthetizing called an epidural analgesia, in which a needle is inserted near the spinal column.
Narcotics are then injected to eliminate all feeling in the patient's lower body, leaving her awake for the operation.
The researchers presented their study Oct. 12 at the annual meeting of the American Society of Anesthesiologists.
Elizabeth Bell, lead author of the study and an assistant professor of anesthesiology, said the study generated a great deal of interest and that she called for a national, multi-center trial test.
"There is a definite need to examine this issue for differences in regionality, socioeconomics and nationality," Bell said. She added that there is also a push to find the BMI that points to obesity during pregnancy, which is probably a bit higher than the traditional 30.
The usefulness of the BMI is limited in persons with very high muscle masses, such as bodybuilders and professional athletes.
"This [limitation] only applies to about half a percent of the population, most of whom are men," said Peter Dwane, assistant clinical professor in the department of anesthesiology. "And when dealing women, it's almost completely insignificant."
Until the trend is studied in more depth, Bell offered some advice for all expectant mothers.
"I see in these popular magazines numerous articles about what a woman should do to have a healthy baby-my simple advice is 'Don't gain over 100 pounds,'" said Bell.
"Of course, this doesn't mean that a pregnant mother should diet-simply that she should monitor the type and quality of food she eats during pregnancy," she concluded.
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