Obesity and Delivery. Women whoare obese before pregnancy are morelikely to experience difficulties duringlabor and delivery. Obese women arealmost two times more likely to experienceinduction of labor compared towomen with a BMI <25.24,31 The likelihoodof induction secondary to achronic condition during pregnancy iseven higher, with the risk of inductionquadrupled among obese womenwith hypertension and the risk ofinduction increased more than 11-foldamong obese women with GDM.Cesarean-section deliveries occurtwice as frequently among obesewomen.20,22,24,31 Women with a prepregnancyBMI 30 are more thanthree times more likely to experience acesarean section secondary to preeclampsia,and nearly twice as likelyto have a cesarean-section delivery as aresult of fetal distress or failure toprogress in labor compared to normalweightwomen. Cesarean sectiondelivery has been estimated to occur in26.5% of deliveries among normalweightwomen, 38.2% of deliveries towomen with class I obesity, 43.1% ofdeliveries to women with class IIobesity, and 49.7% of women with classIII obesity.20Postpartum hemorrhage is one of theleading causes of maternal mortality.Maternal obesity is thought to be oneof the main drivers of the globalincrease in postpartum hemorrhagethat has occurred in the past few decades.34Nulliparous obese womenhave been found to be at double therisk for postpartum hemorrhage, irrespectiveof the mode of delivery(vaginal vs cesarean section). Womenwith pre-eclampsia are also at highrisk for postpartum hemorrhage, withobesity being a risk factor for bothconditions.
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