Caesarean section by maternal age group among singleton deliveries and primiparous Japanese women: a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health

Yoshioka-Maeda, Kyoko; Ota, Erika; Ganchimeg, Togoobaatar; Kuroda, Mariko; Mori, Rintaro

doi:10.1186/s12884-016-0830-2

Cited by 22 publications

(19 citation statements)

References 21 publications

(9 reference statements)

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“…In a systematic review of 21 studies, AMA was confirmed to be an independent risk factor for CS in both nulliparous women and multiparous women . However, the actual mechanisms of the increase of CS with age were not established, although many causes have been proposed, including deterioration of uterine function with increasing maternal age and decreased number of oxytocin receptors, increased rates of chronic medical diseases and previous uterus scar and maternal complications, not to mention the possibility of reduced clinical threshold for obstetric interventions . In our study, an increasing odds ratio of CS could be observed in older parturients (Table ), which was not attenuated after adjustment for obstetric and other demographic factor (Table ), thus suggesting that AMA per se was an independent risk factor for CS.…”

Section: Discussionsupporting

confidence: 42%

“…In our study, an increasing odds ratio of CS could be observed in older parturients (Table ), which was not attenuated after adjustment for obstetric and other demographic factor (Table ), thus suggesting that AMA per se was an independent risk factor for CS. Furthermore, similar to most other prior studies, the effect of maternal age on the risk of CS was much greater in nulliparous parturients.…”

Section: Discussionsupporting

confidence: 42%

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Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

Xie

Lao

et al. 2019

J. Obstet. Gynaecol. Res.

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Aim: To describe changed epidemiological features of advanced maternal age (AMA) and to examine the effect of AMA on the risk for Cesarean section (CS) in a Chinese pregnant population. Methods: This retrospective single-center cohort study investigated the changes of epidemiological features of AMA parturients with respect to the revised reproductive policy in China in 43 702 singleton deliveries with live birth at ≥28 weeks managed from January 2005 to December 2016. We also evaluated the pregnancy outcomes in different age groups and risk factors of CS with multivariate analysis. Results: In this 12-year study period, the average maternal age increased from 28.5 to 30.2 years, and the proportion of AMA raised from 6.5% to 17.2%. AMA was significantly associated with increased risk of adverse pregnancy outcomes, and after adjustment for confounding factors, AMA remained a significant independent risk factor for CS. Furthermore, the effect of AMA in nulliparous women on the risk of CS was more significant than in multiparous women, while the history of previous CS (adjusted odds ratio 39.85) and interdelivery interval ≥10 years (adjusted odds ratio 1.52) also increased the risk of CS in multiparous women. Conclusion: AMA increased the risk of a number of adverse pregnancy outcomes, and was independently associated with increased risk for CS. The increasing number of AMA parturients with risk factors is likely to increase CS rate in China in the near future, thus it is imperative to reduce the rate of primary CS as a matter of policy.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionsupporting

confidence: 42%

Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

Xie

Lao

et al. 2019

J. Obstet. Gynaecol. Res.

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“…A recent study conducted in Bangladesh and other developing countries stated that women's advanced maternal age are more likely to suffer from obstetric and maternal complications than women in middle maternal age, and this may subsequently contribute to the increasing rate of C section deliveries. [25][26][27][28] There was a negative relationship found between birth order and Csection deliveries. It may be due to the fact that the increase in the birth order implies the women are getting more experienced regarding delivery procedures and the chances of having serious complications get reduced.…”

Section: Discussionmentioning

confidence: 95%

Prevalence and determinants of voluntary caesarean deliveries and socioeconomic inequalities in India: Evidence from National Family Health Survey (2015-16)

Singh

Vishwakarma

Sharma

2020

Clinical Epidemiology and Global Health

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Introduction: With a substantial increase in Institutional births in India, the prevalence of C-section section deliveries witnessed a sharp rise, with a highly skewed prevalence among births in private health facilities. The study aims to investigate the dynamics of voluntary C-section across different socio-cultural strata in India, along its major drivers. Methods: The study used data on 249,949 live births in the five years preceding 2015-16 NFHS-4 covering 699,686 women from 601,000 households across 640 districts in the country. Bivariate and binary logistic regression analysis have been used to analyses the data. The economic inequalities in voluntary C-section have been analyzed using the poor-rich ratio and the concentration index (CI) Results: Seventeen percent of live births in five years preceding NFHS-4 were delivered by C-section, a sharp rise from 9% in 2005-06. C-section deliveries are common among first births (24%), in private sector health facilities (41% of deliveries), higher educated mothers and those residing in urban areas (28%). The likelihood of Csection deliveries is significantly higher among mother from high-income families. Values of the poor-rich ratio (0.092) and concentration index (0.031) has significantly revealed that voluntary C-section is more concentrated among the affluent class of households in India. Conclusions:The study concludes that older women, higher educated mothers, residing in urban areas and, belonging to high socio-economic status are the ones who opt for voluntary C-section deliveries and seek private instructional delivery. The government of India should strengthen the regulatory protocol for private health facilities.

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“…Several previous studies document a significant association between advanced maternal age (>35 years) and an increased likelihood of CS birth [19,20]. This association may be interpreted as a result of a changing social environment, but a common explanation is the pre-pregnancy morbidities associated in these cases [21].…”

Section: Discussionmentioning

confidence: 96%

Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain

Vila-Candel¹,

Martín

Escuriet

et al. 2020

IJERPH

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Background: The WHO recommends the use of the Robson ten-group classification system (RTGCS) as an effective monitoring and analysis tool to assess the use of caesarean sections (CS). The present study aimed to conduct an analysis of births using the RTGCS in La Ribera University Hospital over nine years and to assess the levels and trends of CS births. Methods: Retrospective study between January 1, 2010, and December 31, 2018. All eligible women were allocated in RTGCS to determine the absolute and relative contribution made by each group to the overall CS rate; linear regression and weighted least squares regression analysis were used to analyze trends over time. The risk of CS of women with induced versus spontaneous onset of labor was calculated with an odds ratio (OR) with a 95% CI. Results: 16,506 women gave birth during the study period, 19% of them by CS. Overall, 20.4% of women were in group 1 (nulliparous, singleton cephalic, term, spontaneous labor), 29.4% in group 2 (nulliparous, singleton cephalic, term, induced labor or caesarean before labor), and 12.8% in group 4 (multiparous, singleton cephalic, term, induced or caesarean delivery before labor) made the most significant contributions to the overall rate of CS; Conclusions: In our study, Robson Groups 1, 2, and 4, were identified as the main contributors to the hospital's overall CS rate. The RTGCS provides an easy way of collecting information about the CS rate, is a valuable clinical method that allows standardized comparison of data, and time point, and identifies the groups driving changes in CS rates. justification do not reduce maternal or infant death rates if carried out at a rate higher than 10%-15% [2]. The unjustified, excessive use of clinical procedures can lead to an ever-increasing therapeutic cascade of avoidable interventions [3] and become life-threatening in the present or future pregnancies for both the women and children [4]. The worldwide rise in CS rates has become a growing public health concern and a cause for debate due to potential maternal and perinatal risks, cost issues, and inequity in access [5].There is a high degree of variability in the reported crude rates of CS performed in different countries and regions, and there are often even significant differences between hospitals within a single region. The highest caesarean rates are observed in the Dominican Republic (56.4%), Brazil (55.6%), and Egypt (51.8%), with Africa (7.3%) showing the lowest proportion of these procedures [1]. In most European countries, the rates are about 25% to 35% [5]. In Spain, the average CS rate reported across the 17 autonomous communities, the governing entities independently responsible for health care [6] and for deploying health resources to serve the needs of their local populations, was found to be 24.5% in 2015 [7,8]. However, due to the decentralized structure of the health system, there is no nationally established system to monitor the use of caesarean procedures.Achieving reductions in maternal and infant morbidity and morta...

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Caesarean section by maternal age group among singleton deliveries and primiparous Japanese women: a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health

Cited by 22 publications

References 21 publications

Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

Risk for Cesarean section in women of advanced maternal age under the changed reproductive policy in China: A cohort study in a tertiary hospital in southwestern China

Prevalence and determinants of voluntary caesarean deliveries and socioeconomic inequalities in India: Evidence from National Family Health Survey (2015-16)

Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain

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