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Cesarean for non-reassuring fetal status: effect of obesity on decision to delivery interval



To evaluate the impact of obesity on the decision to delivery interval.

Study design

We compared the interval to delivery in normal, obese (BMI 30–40 kg/m2), and morbidly obese (BMI over 40 kg/m2) women. In a planned sub-analysis, we evaluated those who underwent emergency cesarean.


We included 447 (25.3%) subjects: 157 normal, 200 obese, and 90 morbidly obese. We found no significant difference in the decision to delivery interval, mean ± SD (minutes): 39 ± 24, 44 ± 28, and 46 ± 28, p = 0.10. In the setting of emergency delivery we did find significantly prolonged intervals: 18 ± 8, 23 ± 16, and 30 ± 19 in non-obese, obese, and morbidly obese, respectively, p = 0.04.


We found similar decision to delivery intervals in women of varying BMI. In the setting of emergency cesarean delivery, we found increasing BMI to be associated with significant delays to delivery.

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Study data were collected and managed with REDCap software (Research Electronic Data Capture), which is hosted at Cincinnati Children’s Hospital Medical Center under the Center for Clinical and Translational Science and Training grant support (UL1-RR026314–01 NCRR/NIH). REDCap is a secure, web-based application that was designed to support data capture for research studies to provide (1) an intuitive interface for validated data entry, (2) audit trails for tracking data manipulation and export procedures, (3) automated export procedures for seamless data downloads to common statistical packages and (4) procedures for importing data from external sources. EDF’s contribution to this work was supported by the Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA.

Author information

Both the authors contributed substantially to the production of this work.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This work was approved by the local Institutional Review Board.

Correspondence to Carri R. Warshak.

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