Impact of obesity on the incidence of complications in cesarean section
DOI:
https://doi.org/10.37800/RM.2.2026.693Keywords:
obesity, body mass index, cesarean section, intraoperative complications, postoperative complications, surgical site infection, thromboembolic complications, pregnancyAbstract
Relevance: Obesity among women of reproductive age is a growing public health challenge, including during pregnancy. Excess body weight increases the risk of obstetric and surgical complications, especially in cesarean deliveries. Although international data exist, the impact of obesity severity on intraoperative and postoperative complications in domestic practice remains understudied, highlighting the need for further research.
The study aimed to assess the impact of body mass index (BMI) on the frequency and nature of intraoperative, postoperative, and neonatal complications associated with cesarean section.
Materials and Methods: A retrospective cohort analysis of medical records from patients who underwent cesarean delivery at the obstetric hospitals in Shakhtinsk (Kazakhstan) from 2023 to 2025 was conducted. Patients were stratified according to the World Health Organization BMI classification. Intraoperative parameters, postoperative complications, and neonatal outcomes were evaluated. Statistical analysis included the chi-square test, t-test, ANOVA, correlation analysis, and calculation of relative risks.
Results: A significant increase in the frequency of intra- and postoperative complications was established as BMI increased. In patients with obesity, higher blood loss, increased duration of surgery, increased frequency of transition to general anesthesia, and organ trauma were noted. Postoperative infectious complications, seroma, endometritis, and thromboembolic events were significantly more common in grade II-III obesity. A positive correlation between BMI and the risk of postoperative wound infections and surgical duration was revealed. In addition, a worsening of neonatal outcomes in patients with high BMI was established: the frequency of macrosomia and respiratory disorders in newborns increased, as well as the frequency of admission to the neonatal intensive care unit. Grade II-III obesity significantly increased the risk of postoperative wound infection and long-term hospitalization.
Conclusion: Obesity is an independent risk factor for adverse cesarean section outcomes. Higher obesity severity increases surgical, anesthetic, and infectious complications, highlighting the need for individualized management and optimized preventive strategies.
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