Birth Outcomes of Women with Obesity Enrolled for Care at Freestanding Birth Centers in the United States.
Cecilia M Jevitt, Susan Stapleton, Yanhong Deng and 3 others
PMID 33377279WHAT IT FOUND
Low-risk primiparous women with obesity in US birth centers had similar newborn outcomes to normal-weight women.
They had higher hospital transfer rates (30.7% vs 19.9%) and cesarean rates (11.1% vs 5.8%), but these remained lower than national averages.
Key findings
01Primiparous women with obesity had significantly higher intrapartum transfer rates to hospitals compared to women with normal BMI.
02Women with obesity had higher rates of cesarean birth and lower vaginal birth rates than the normal BMI group, though both remained lower than typical US obstetric unit rates.
03Newborn outcomes, including Apgar scores and transfer rates, did not differ significantly between the obesity and normal BMI groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only included primiparous women, so results do not apply to women having their second or subsequent births. Women with significant comorbidities like diabetes or chronic hypertension were excluded, limiting generalizability to higher-risk obesity populations. The study did not account for excess gestational weight gain, which is a known risk factor for adverse outcomes. It is unknown how women with missing BMI data differed from those included in the analysis. The data comes from birth centers voluntarily participating in the registry, which may not represent all US birth centers.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the lower cesarean and transfer rates compared to national averages as evidence that birth centers are universally safer for women with obesity. The transfer rate for women with obesity was still significantly higher (30.7%) than for normal-weight women (19.9%), indicating a substantial likelihood of needing acute care intervention during labor.