Body mass index-related cesarean section complications in sub-Saharan Africa: A systematic review and meta-analysis.
Int J Gynaecol Obstet 2021;
157:514-521. [PMID:
34498263 DOI:
10.1002/ijgo.13923]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/26/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND
Obesity and cesarean section (CS) rates are rising in sub-Saharan Africa (SSA), where risks for complications that adversely affect maternal health, such as infections, are high.
OBJECTIVE
To conduct a systematic review and meta-analysis to report on the incidence and types of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters)-related complications following CS in SSA.
SEARCH STRATEGY
A systematic search was conducted in PubMed/MEDLINE, EMBASE, and Global Health Library up to August 2020 using (MeSH) terms related to CS, BMI, and SSA.
SELECTION CRITERIA
Quantitative studies that evaluated BMI-related complications of CS in English.
DATA COLLECTION AND ANALYSIS
Data were extracted using a standardized form. The risk of bias was assessed using the Newcastle-Ottawa Scale. The incidence of BMI-related complications at 95% confidence interval was calculated and a meta-analysis conducted.
MAIN RESULTS
Of 84 articles screened, five were included. Complications associated with a higher BMI were: wound infection, hemorrhage, post-dural puncture headache, and prolonged surgery time in comparison with patients with a normal BMI. Women with a high BMI (>25.0) have a two-fold increased risk for post-cesarean wound infection compared with women with a normal BMI (20.0-24.9) (odds ratio 1.91, 95% confidence interval 1.11-3.52).
CONCLUSION
Overweight and obesity were associated with CS complications in SSA, but limited research is available.
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