{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T08:40:57Z","timestamp":1768034457108,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T00:00:00Z","timestamp":1600041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare neonatal outcomes of women with a body mass index (BMI) of \u226535\u00a0kg\/m<jats:sup>2<\/jats:sup> who underwent a trial of labour with those of women who underwent a planned primary caesarean section (CS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort study of births between April 2012 and March 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A provincial database: Better Outcomes Registry &amp; Network (BORN) Ontario, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A cohort of 8752 women with a BMI of \u226535\u00a0kg\/m<jats:sup>2<\/jats:sup> who had a singleton birth at 38\u201342\u00a0weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Neonatal outcomes were compared between women who underwent a trial of labour (with either a successful vaginal birth or intrapartum CS) and those who underwent a planned CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>A composite of any of the following outcomes: intrapartum neonatal death, neonatal intensive care unit admission, 5\u2010minute Apgar score of &lt;7 or umbilical artery pH of &lt;7.1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 8433 (96.4%) women had a trial of labour and 319 (3.6%) had a planned CS. Intrapartum CS was performed in 1644 (19.5%) cases. There was no association between planned mode of delivery and the primary outcome (aOR\u00a00.80, 95%\u00a0CI 0.59\u20131.07). The primary outcome was lower among women who had a successful trial of labour (aOR\u00a00.67, 95%\u00a0CI 0.50\u20130.91) and was higher among women who had a failed trial of labour (aOR\u00a01.74, 95%\u00a0CI 1.21\u20132.48), compared with women who underwent a planned CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with a BMI of \u226535\u00a0kg\/m<jats:sup>2<\/jats:sup> at a gestational age of 38\u201342\u00a0weeks, neonatal outcomes are comparable between planned vaginal delivery and planned CS, although a failed trial of labour is at risk of adverse neonatal outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Neonatal outcomes are not affected by planned mode of delivery in women who are obese, with a BMI of \u226535\u00a0kg\/m<jats:sup>2<\/jats:sup>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16467","type":"journal-article","created":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T13:57:23Z","timestamp":1597327043000},"page":"900-906","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Neonatal outcome by planned mode of delivery in women with a body mass index of 35 or more: a retrospective cohort study"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4861-2941","authenticated-orcid":false,"given":"K","family":"Tzadikevitch\u2010Geffen","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"},{"name":"Maternal\u2010Fetal Medicine Unit Department of Obstetrics and Gynecology North York General Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-1385","authenticated-orcid":false,"given":"N","family":"Melamed","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2741-3679","authenticated-orcid":false,"given":"A","family":"Aviram","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynecology Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AE","family":"Sprague","sequence":"additional","affiliation":[{"name":"Better Outcomes Registry &amp; 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