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BMI-related cesarean section complications in Sub-Saharan Africa: A systematic review and meta-analysis.

PMID: 34498263 (view PubMed database entry)
DOI: 10.1002/ijgo.13923 (read at publisher's website )

Kwaku Asah-Opoku, Iris Pijtak, Mercy Nuamah, Nelson Damale, Kitty Bloemenkamp, Joyce Browne, Marcus J Rijken,

<h4>Background</h4>Obesity and cesarean section (CS) rates are rising in Sub-Saharan African (SSA), where risks for complications that adversely affect maternal health such as infections, are high.<h4>Objective</h4>To conduct a systematic review and meta-analysis to report on the incidence and types of body mass index (BMI)-related complications following CS in SSA.<h4>Search strategy</h4>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.<h4>Selection criteria</h4>Quantitative studies that evaluated BMI related complications of CS in English.<h4>Data collection and analysis</h4>Data were extracted using a standardized form. Risk of bias was assessed using the Newcastle-Ottawa Scale. Incidence of BMI related complications at 95% CI were calculated and a meta-analysis conducted.<h4>Main results</h4>Of 84 articles screened, five were included. Complications associated with a higher BMI were: wound infection, hemorrhage, postdural puncture headache and prolonged surgery time in comparison to patients with normal BMI. Women with high BMI (>25kg/m2) have a two- fold increased risk for post-cesarean wound infection compared to women with normal BMI (BMI 20-24.9kg/m2) (OR 1.91, 95%-CI 1.11-3.52) CONCLUSION: Overweight and obesity were associated with CS complications in SSA, but limited research is available.

Int J Gynaecol Obstet (International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics)
[2021, :]

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