Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia

Marcio Luiz Benevides; Anne Karoline Coutinho Borges; Luiz Fernando Galesso Seror; Danilo Augusto Oliani Giroto; Aleandra Simoes Furtado; Amanda Costa Pinto; Marco Antonio Marquioreto Benevides

doi:doi:10.11648/j.ijacm.20221002.11

Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia

Marcio Luiz Benevides, Anne Karoline Coutinho Borges, Luiz Fernando Galesso Seror, Danilo Augusto Oliani Giroto, Aleandra Simoes Furtado, Amanda Costa Pinto, Marco Antonio Marquioreto Benevides

Published in International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 2)

Received: 26 June 2022 Accepted: 15 July 2022 Published: 20 July 2022

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Abstract

Introduction: Obese pregnant women, especially morbidly obese, are at greater risk of undergoing a cesarean section (CS). Clinical outcomes have been associated with an increase in body mass index (BMI). Objective: The objective of the study was to evaluate the sensory block level, the perioperative times, the incidence of maternal hypotension, the Apgar score, and the birth weight between the BMI strata of pregnant women undergoing CS. Method: In this prospective cohort study were included women with singleton pregnancies undergoing spinal anesthesia for elective CS. The pregnant women were classified according to BMI at delivery: normal (18.5–25 kg.m^-2), overweight (25–29.9 kg.m^-2), obese (30–39.9 kg.m^-2), and morbidly obese (≥ 40 kg.m^-2). The primary outcome was the total operative time. Results: Among 540 patients analyzed, 252 (46.7%) were obese and 54 (10%) were morbidly obese. The sensory block level (> T4) was higher in morbidly obese patients (18.5%) compared to patients with normal BMI (4%) and overweight (7.5%), p < 0.05. The median and interquartile range of the spinal-to-incision interval was longer in morbidly obese patients [13 (10–16.2) minutes] compared with normal BMI [10 (8–12) minutes] and overweight [10 (9.5–14) minutes], p < 0.000; and obese [11 (10–15) minutes], p < 0.00. Also, it was longer in obese patients compared with normal BMI, p < 0.00. The mean and standard deviation (SD) of the total operative time was longer in morbidly obese patients (70.2 ± 21 minutes) compared to those with normal BMI (59.7 ± 12 minutes) and overweight (61.3 ± 17 minutes), p < 0.00; and in obese (65.4 ± 18 minutes) compared with normal BMI, p < 0.05. The incidence of maternal hypotension was higher in morbidly obese patients (79.6%) compared with normal BMI (58.7%) and overweight (61%), p < 0.05; and in obese patients (71.8%) compared with normal BMI and overweight, p < 0.05. The birth weight of morbidly obese patients (3,553 ± 623 g) was higher than in patients with normal BMI (3,020 ± 626 g) and overweight (3,187 ± 587 g), p < 0.000; and in obese patients compared with normal BMI and overweight, p < 0.00. The incision-to-delivery interval, Apgar score < 7 at 5 minutes were similar in the different BMI strata. Conclusion: The increase in BMI is associated with longer perioperative times, higher sensory block level, higher incidence of maternal hypotension, and higher birth weight.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 2)
DOI	10.11648/j.ijacm.20221002.11
Page(s)	44-51
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Obesity, Cesarean Section, Operative Times, Spinal Anesthesia, Maternal Hypotension

References

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Marcio Luiz Benevides, Anne Karoline Coutinho Borges, Luiz Fernando Galesso Seror, Danilo Augusto Oliani Giroto, Aleandra Simoes Furtado, et al. (2022). Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 10(2), 44-51. https://doi.org/10.11648/j.ijacm.20221002.11

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ACS Style

Marcio Luiz Benevides; Anne Karoline Coutinho Borges; Luiz Fernando Galesso Seror; Danilo Augusto Oliani Giroto; Aleandra Simoes Furtado, et al. Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. Int. J. Anesth. Clin. Med. 2022, 10(2), 44-51. doi: 10.11648/j.ijacm.20221002.11

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AMA Style

Marcio Luiz Benevides, Anne Karoline Coutinho Borges, Luiz Fernando Galesso Seror, Danilo Augusto Oliani Giroto, Aleandra Simoes Furtado, et al. Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. Int J Anesth Clin Med. 2022;10(2):44-51. doi: 10.11648/j.ijacm.20221002.11

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@article{10.11648/j.ijacm.20221002.11,
  author = {Marcio Luiz Benevides and Anne Karoline Coutinho Borges and Luiz Fernando Galesso Seror and Danilo Augusto Oliani Giroto and Aleandra Simoes Furtado and Amanda Costa Pinto and Marco Antonio Marquioreto Benevides},
  title = {Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {2},
  pages = {44-51},
  doi = {10.11648/j.ijacm.20221002.11},
  url = {https://doi.org/10.11648/j.ijacm.20221002.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221002.11},
  abstract = {Introduction: Obese pregnant women, especially morbidly obese, are at greater risk of undergoing a cesarean section (CS). Clinical outcomes have been associated with an increase in body mass index (BMI). Objective: The objective of the study was to evaluate the sensory block level, the perioperative times, the incidence of maternal hypotension, the Apgar score, and the birth weight between the BMI strata of pregnant women undergoing CS. Method: In this prospective cohort study were included women with singleton pregnancies undergoing spinal anesthesia for elective CS. The pregnant women were classified according to BMI at delivery: normal (18.5–25 kg.m-2), overweight (25–29.9 kg.m-2), obese (30–39.9 kg.m-2), and morbidly obese (≥ 40 kg.m-2). The primary outcome was the total operative time. Results: Among 540 patients analyzed, 252 (46.7%) were obese and 54 (10%) were morbidly obese. The sensory block level (> T4) was higher in morbidly obese patients (18.5%) compared to patients with normal BMI (4%) and overweight (7.5%), p p p p p p p p p p Conclusion: The increase in BMI is associated with longer perioperative times, higher sensory block level, higher incidence of maternal hypotension, and higher birth weight.},
 year = {2022}
}

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TY  - JOUR
T1  - Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia
AU  - Marcio Luiz Benevides
AU  - Anne Karoline Coutinho Borges
AU  - Luiz Fernando Galesso Seror
AU  - Danilo Augusto Oliani Giroto
AU  - Aleandra Simoes Furtado
AU  - Amanda Costa Pinto
AU  - Marco Antonio Marquioreto Benevides
Y1  - 2022/07/20
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221002.11
DO  - 10.11648/j.ijacm.20221002.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 44
EP  - 51
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221002.11
AB  - Introduction: Obese pregnant women, especially morbidly obese, are at greater risk of undergoing a cesarean section (CS). Clinical outcomes have been associated with an increase in body mass index (BMI). Objective: The objective of the study was to evaluate the sensory block level, the perioperative times, the incidence of maternal hypotension, the Apgar score, and the birth weight between the BMI strata of pregnant women undergoing CS. Method: In this prospective cohort study were included women with singleton pregnancies undergoing spinal anesthesia for elective CS. The pregnant women were classified according to BMI at delivery: normal (18.5–25 kg.m-2), overweight (25–29.9 kg.m-2), obese (30–39.9 kg.m-2), and morbidly obese (≥ 40 kg.m-2). The primary outcome was the total operative time. Results: Among 540 patients analyzed, 252 (46.7%) were obese and 54 (10%) were morbidly obese. The sensory block level (> T4) was higher in morbidly obese patients (18.5%) compared to patients with normal BMI (4%) and overweight (7.5%), p p p p p p p p p p Conclusion: The increase in BMI is associated with longer perioperative times, higher sensory block level, higher incidence of maternal hypotension, and higher birth weight.
VL  - 10
IS  - 2
ER  -

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Author Information

Marcio Luiz Benevides

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Anne Karoline Coutinho Borges

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Luiz Fernando Galesso Seror

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Danilo Augusto Oliani Giroto

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Aleandra Simoes Furtado

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Amanda Costa Pinto

Department of Anesthesiology, General and Maternity Hospital of Cuiaba, Cuiaba, Brazil
Marco Antonio Marquioreto Benevides

Medical School, University of Cuiaba, Cuiaba, Brazil

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Marcio Luiz Benevides, Anne Karoline Coutinho Borges, Luiz Fernando Galesso Seror, Danilo Augusto Oliani Giroto, Aleandra Simoes Furtado, et al. (2022). Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 10(2), 44-51. https://doi.org/10.11648/j.ijacm.20221002.11

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ACS Style

Marcio Luiz Benevides; Anne Karoline Coutinho Borges; Luiz Fernando Galesso Seror; Danilo Augusto Oliani Giroto; Aleandra Simoes Furtado, et al. Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. Int. J. Anesth. Clin. Med. 2022, 10(2), 44-51. doi: 10.11648/j.ijacm.20221002.11

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AMA Style

Marcio Luiz Benevides, Anne Karoline Coutinho Borges, Luiz Fernando Galesso Seror, Danilo Augusto Oliani Giroto, Aleandra Simoes Furtado, et al. Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia. Int J Anesth Clin Med. 2022;10(2):44-51. doi: 10.11648/j.ijacm.20221002.11

Copy | Download

@article{10.11648/j.ijacm.20221002.11,
  author = {Marcio Luiz Benevides and Anne Karoline Coutinho Borges and Luiz Fernando Galesso Seror and Danilo Augusto Oliani Giroto and Aleandra Simoes Furtado and Amanda Costa Pinto and Marco Antonio Marquioreto Benevides},
  title = {Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {2},
  pages = {44-51},
  doi = {10.11648/j.ijacm.20221002.11},
  url = {https://doi.org/10.11648/j.ijacm.20221002.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221002.11},
  abstract = {Introduction: Obese pregnant women, especially morbidly obese, are at greater risk of undergoing a cesarean section (CS). Clinical outcomes have been associated with an increase in body mass index (BMI). Objective: The objective of the study was to evaluate the sensory block level, the perioperative times, the incidence of maternal hypotension, the Apgar score, and the birth weight between the BMI strata of pregnant women undergoing CS. Method: In this prospective cohort study were included women with singleton pregnancies undergoing spinal anesthesia for elective CS. The pregnant women were classified according to BMI at delivery: normal (18.5–25 kg.m-2), overweight (25–29.9 kg.m-2), obese (30–39.9 kg.m-2), and morbidly obese (≥ 40 kg.m-2). The primary outcome was the total operative time. Results: Among 540 patients analyzed, 252 (46.7%) were obese and 54 (10%) were morbidly obese. The sensory block level (> T4) was higher in morbidly obese patients (18.5%) compared to patients with normal BMI (4%) and overweight (7.5%), p p p p p p p p p p Conclusion: The increase in BMI is associated with longer perioperative times, higher sensory block level, higher incidence of maternal hypotension, and higher birth weight.},
 year = {2022}
}

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TY  - JOUR
T1  - Body Mass Index and Clinical Outcomes During Cesarean Section Under Spinal Anesthesia
AU  - Marcio Luiz Benevides
AU  - Anne Karoline Coutinho Borges
AU  - Luiz Fernando Galesso Seror
AU  - Danilo Augusto Oliani Giroto
AU  - Aleandra Simoes Furtado
AU  - Amanda Costa Pinto
AU  - Marco Antonio Marquioreto Benevides
Y1  - 2022/07/20
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221002.11
DO  - 10.11648/j.ijacm.20221002.11
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 44
EP  - 51
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221002.11
AB  - Introduction: Obese pregnant women, especially morbidly obese, are at greater risk of undergoing a cesarean section (CS). Clinical outcomes have been associated with an increase in body mass index (BMI). Objective: The objective of the study was to evaluate the sensory block level, the perioperative times, the incidence of maternal hypotension, the Apgar score, and the birth weight between the BMI strata of pregnant women undergoing CS. Method: In this prospective cohort study were included women with singleton pregnancies undergoing spinal anesthesia for elective CS. The pregnant women were classified according to BMI at delivery: normal (18.5–25 kg.m-2), overweight (25–29.9 kg.m-2), obese (30–39.9 kg.m-2), and morbidly obese (≥ 40 kg.m-2). The primary outcome was the total operative time. Results: Among 540 patients analyzed, 252 (46.7%) were obese and 54 (10%) were morbidly obese. The sensory block level (> T4) was higher in morbidly obese patients (18.5%) compared to patients with normal BMI (4%) and overweight (7.5%), p p p p p p p p p p Conclusion: The increase in BMI is associated with longer perioperative times, higher sensory block level, higher incidence of maternal hypotension, and higher birth weight.
VL  - 10
IS  - 2
ER  -

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