Table 4.2GRADE summary of findings for risks of planned CS compared with planned vaginal birth for women with BMI of 50 kg/m2 or more and no previous CS (maternal outcomes)

Number of studiesPercentage of unplanned CS in planned vaginal birth groupNumber of womenEffectQuality
Planned CSPlanned vaginal birthRelative (95% CI)Absolute
Infection (wound and postpartum)
1 study

(Homer et al., 2011)



OR 0.79

(0.46 to 1.35)
43 more per 1000

(from 121 fewer to 62 more)
Anaesthetic complication
1 study

(Homer et al., 2011)



OR 1.25

(0.69 to 2.29)
19 more per 1000

(from 24 fewer to 89 more)
Major maternal morbidity (composite score including one or more of: intraoperative or postpartum haemorrhage, thromboembolic event, septicaemia, septic shock and/or admission to intensive care unit)
1 study

(Homer et al., 2011)



OR 1.49

(0.69 to 3.23)
20 more per 1000

(from 13 fewer to 84 more)

Denominator is women who had a CS

BMI body mass index; CI confidence interval; OR odds ratio; RR risk ratio

From: 4, Woman-centred care

Cover of Caesarean Section
Caesarean Section.
NICE Clinical Guidelines, No. 132.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2011 Nov.
Copyright © 2011, National Collaborating Centre for Women's and Children's Health.

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