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Operative Obstetrics

Poster Session 4

(1183) The Impact of Body Mass Index on Cesarean Delivery Duration

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Prolonged operative durations are known to increase complications. In obstetrics, prolonged operative times in repeat cesarean deliveries (CD) are known to be a marker for adverse maternal outcomes, with higher maternal body mass index (BMI) potentially being a risk factor. In this study, we sought to compare the length of operative times of CDs across various BMI categories to determine how elevated BMI impacts operating time.

Study Design:

We performed a single center, retrospective study comparing CD operating times and maternal BMI from July 2021 to December 2022. In this review, we compared total length of time in the operating room (OR), time from skin closure to OR exit, and time from placental delivery to exit. BMI ranges were defined as <30m/kg2, 30-39.9 m/kg2, 40-49.9 m/kg2, and ≥50 m/kg2. Patient exclusion criteria included multifetal gestation and emergent CD. Linear regression models compared BMI categories. Covariates included the total blood loss, concern for bladder or bowel injury, and number of prior CDs. 


Results:

A total of 1647 patients were included in the study, with 47 being omitted due to missing data. Regression analysis comparing total OR times showed BMI <30 m/kg2 required significantly less OR time than the 40-49.9 m/kg2[95%CI (6.83-19.85), p= < 0.001] and ≥50 m/kg2 [95%CI (39.67-61.79), p= < 0.001]. Patients with BMI ≥50 m/kg2 had significantly greater total time in the OR compared to BMI 40-49.9 m/kg2. For placental delivery to exit, the BMI of < 30 m/kg2 group was significantly less than all other categories. Skin closure to exit times was significantly faster than the group of BMI ≥50 m/kg2[95%CI (24.58-34.46), p= < 0.001], but there was no significant difference between patients with BMIs <30m/kg2 and those with BMIs of 30-39.9 m/kg2 or 40-49.9 m/kg2.


Conclusion:

Operative times vary based on patients’ BMI, with heavier patients having significantly longer procedures. Body mass index ≥50 m/kg2 had the greatest impact on increased total OR time. Given this data, increased BMI may be associated with an increased risk of operative complications and hospital costs.