The impact of maternal body mass index on external cephalic version success

Shahrukh Chaudhary, Stephen Contag, Ruofan Yao

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


OBJECTIVE: The purpose of this study is to determine the association between body mass index (BMI) and success of ECV.

METHODS: This is a cross-sectional analysis of singleton live births in the USA from 2010 to 2014 using birth certificate data. Patients were assigned a BMI category according to standard WHO classification. Comparisons of success of ECV between the BMI categories were made using chi-square analysis with normal BMI as the reference group. Cochran-Armitage test was performed to look for a trend of decreasing success of ECV as BMI increased. The odds for successful ECV were estimated using multivariate logistic regression analysis, adjusting for possible confounders.

RESULTS: A total of 51,002 patients with documented ECV were available for analysis. There was a decreased success rate for ECV as BMI increased (p < .01). Women with a BMI of 40 kg/m 2 or greater had a 58.5% success rate of ECV; women with a normal BMI had 65.0% success rate of ECV. Multivariate analyses demonstrated significant decrease in success of ECV in women with BMI of 40 kg/m 2 or greater (OR 0.621, CI 0.542-0.712). Among women with BMI of 40 kg/m 2 or greater with successful ECV, 59.5% delivered vaginally. In contrast, 81.0% of women with normal BMI and successful ECV delivered vaginally.

CONCLUSIONS: Morbidly obese women have decreased success rate of ECV as BMI increases and decreased vaginal delivery rates after successful ECV.

Original languageEnglish (US)
Pages (from-to)2159-2165
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number13
StatePublished - Jul 3 2019

Bibliographical note

Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.


  • External cephalic version
  • body mass index
  • breech
  • obesity
  • Body Mass Index
  • Obesity, Morbid/complications
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Logistic Models
  • Treatment Outcome
  • Labor Presentation
  • Chi-Square Distribution
  • Case-Control Studies
  • Version, Fetal/statistics & numerical data
  • Pregnancy
  • Young Adult
  • Delivery, Obstetric/statistics & numerical data
  • Pregnancy Complications/epidemiology
  • Adolescent
  • Adult
  • Female

PubMed: MeSH publication types

  • Journal Article


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