August 2013

UCD/ESRI Study: Obesity in Irish, First-time Mothers Linked with Caesarean Rates

Thu, 15 August 13 11:41

The rate of emergency caesarean section in Irish mothers is twice that of Eastern European women who give birth in Ireland, according to a study from University College Dublin (UCD) and the Economic and Social Research Institute (ESRI).

The results also found that Irish women are more likely to be obese, smoke, and have an induction of pregnancy.

Published in the Journal of Obstetrics and Gynaecology, the research took place from 2008-2011 at the Coombe Women and Infants University Hospital in Dublin, and included 1433 first time mothers from Ireland and the European Union.

The women were divided into three groups: those born in Ireland, those from EU 14 countries (pre-enlargement), and those from EU 12 countries (post-enlargement). The results found that the obesity rate in Irish-born first-time mothers (19.5 per cent) is twice that of mothers who were born in EU 12 post-enlargement countries (9.5 per cent). The authors found that 19.8 per cent of Irish-born women ultimately required an emergency medical caesarean, compared with just 12.5 per cent of women from the EU 12 group.

The results also found that 42.5 per cent of the Irish group had an induction of labour, compared with 31 per cent of the EU 12 group. According to Prof Michael Turner, Consultant Obstetrician at Coombe Women & Infants University Hospital and Head of UCD Centre for Human Reproduction:

The impact of maternal obesity on the baby and the mother’s journey through pregnancy needs to be understood as a continuum, rather than a singular event such as a caesarean. Obesity can be described as having a seriously negative effect on almost every aspect of pregnancy and childbirth. Women who are obese are more likely to develop complications such as gestational diabetes and hypertension. Crucially, obesity in expectant women is also associated with late delivery and induction of labour.

Induction is associated with a higher rate of caesarean section - particularly in first-time mothers – and so the complicating factor of obesity can be said to have a very disruptive and potentially harmful impact on mother and baby from the first trimester through to delivery. It is our view that the induction of obese first-time mothers should be undertaken only in carefully considered circumstances” said Prof Turner.

Professor Richard Layte, economic sociologist at the ESRI said:

We have known for some time that there are ethnic variations in caesarean section rates. For example, in the United States, the rate is higher for African-American women but lower for Hispanic women, even after adjustment for variables.While ethnic factors in the context of caesarean rates are not modifiable; behaviour and clinical strategies are – therefore we recommend careful consideration of the two variables over which first-time mothers and clinicians have influence; namely obesity and the decision to induce,” said Prof Layte.

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