Biel FM et al. – This study investigated the relation between regional anesthesia, mode of delivery, and regional anesthesia complications by pre–pregnancy body mass index (BMI) categories among term deliveries. The authors concluded that regional anesthesia and caesarean delivery are more likely to be associated with laboring women in higher BMI categories compared to normal weight women and women without regional anesthesia. Women in the highest BMI category showed highest rates of anesthesia complications.

Methods

• Retrospective cohort study of births using linked birth certificate and patient discharge data.

Results

• Women undergoing labored delivery with higher BMI categories were more likely to receive regional analgesia in a dose–response fashion and those women who received regional anesthesia, were less likely to deliver vaginally.
• A complex relationship was shown between regional anesthesia complications and maternal BMI, with risk of complications being highest in women with highest BMI (2–fold increase) and decreased in women in intermediate obesity categories.