Re: Moore EK, Irvine LM. 2014. The impact of maternal age over forty years on the caesarean section rate: six year experience at a busy district general hospital. Journal of Obstetrics and Gynaecology 34:238–240

Gerli, Sandro; Favilli, Alessandro; Pericoli, Silvia; Renzo, Gian Carlo Di

doi:10.3109/01443615.2014.960825

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…The perception of risk may lower the threshold for interventions among obstetric personnel [38]. Gerli et al emphasize that the choice of performing a CS could more easily be made among older patients, as the pregnancy tends to be ‘precious’ and at ‘high risk for medical-legal issues’ [32]. A US study found a decrease in CS rates if the birth care provider was favorable toward vaginal birth [46].…”

Section: Discussionmentioning

confidence: 99%

“…A Canadian study found that women with advanced age were more likely to be offered a CS or to ask for it themselves [10]. The challenge for researchers is to disentangle the impact of anxiety and subjective sense of urgency among mothers and the varying obstetric threshold for intervention that may influence the decision to perform a cesarean [16,32,33].…”

Section: Introductionmentioning

confidence: 99%

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Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study

et al. 2019

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BackgroundIn Denmark, the cesarean section rate has increased by 49% between 1998 and 2015 and accounts for 21% of all births. Cesarean sections may cause short- as well as long-term consequences for both the mother and the child and impose further risks in future pregnancies. Delaying pregnancy until advanced maternal age at childbirth has been suggested as contributing to the increase. The proportion of women giving birth at 35 years or above increased from 15% (1998) to 21% (2015). Advanced maternal age at childbirth has been found to be related to increased pre-pregnancy morbidity and associated risk factors that may contribute to an increased risk of cesarean section. The aim of this study was to examine the association between advanced maternal age and cesarean section in a Danish population and the influence of demographic, anthropometric, health, and obstetric factors on this association.MethodsThis study draws on a national population-based cohort study of all Danish births between 1998 and 2015 (N = 1,122,964). Maternal age less than 30 years serves as reference with the following age categories: (30–34 years); (35–39 years), and (40 years and above). The primary outcome was a cesarean section. Multivariate regression models with adjustment for demographic, health, pregnancy, fetal, and obstetric characteristics were performed with the results further stratified by parity.ResultsIn general, a positive association between advanced maternal age and cesarean section was found. Only minor changes in the risk estimate occurred after adjustment for relevant confounders. In comparison with the reference category, nulliparous women aged 35-39- years had twice the risk for cesarean section (adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) [2.11–2.26]) whereas for women of 40 years or above, the risk was more than tripled (AOR 3.64, 95% CI [3.41–3.90]). For multiparous women aged 35-39-years the risk was more moderate, but still with an AOR of 1.56, 95% CI [1.53–1.60], and for those 40 years and above, the AOR was 2.02, 95% CI [1.92–2.09].ConclusionsOverall, cesarean section increased with increasing maternal age. Adjustment for maternal and obstetric risk factors had only a minor influence on the association. The association was stronger in nulliparous women compared to multiparous women. Given the lack of impact of demographic and health risks on the relationship between maternal age and cesarean section, the authors suggest obstetric culture could be added to the list of risk factors for a cesarean. Future research on obstetric culture is recommended as are studies on a possible age-related decrease in the ability to maintain the progression of labor.Trial registrationThe study uses depersonalized register data and has been approved by the Danish Data Protection Agency (2015-41-4168).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study

et al. 2019

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“…The advanced maternal age, particularly in nulliparous women, has been suggested to be a cause of the increment of caesarian sections [ 30 ]. This observation may reflect the proneness to a more medicalized approach by the clinicians to an advanced maternal age pregnancy, adopting a lowered treatment threshold for interventions [ 31 , 32 ] as the pregnancy tends to be “precious” and at “high risk for medical-legal issues” [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The role of maternal age on the risk of preterm birth among singletons and multiples: a retrospective cohort study in Lombardy, Northern Italy

Esposito

Mauri

Cipriani

et al. 2022

BMC Pregnancy Childbirth

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Background All over the world, especially in the developed countries, maternal age at birth is rising. This study aimed to assess the role of maternal age on the occurrence of preterm birth (PTB) in a large birth cohort of Lombardy Region, Northern Italy. Methods This population-based study used data from regional healthcare utilization databases of Lombardy to identify women who delivered between 2007 and 2017. PTBs were defined as births before 37 completed weeks of gestation and considered according to the gestational age (two categories: < 32 weeks and 32 to 36 weeks). Six maternal age groups were defined (< 20, 20–24, 25–29, 30–34, 35–39, ≥40 years). Logistic regression models were fitted to estimate the crude and adjusted odds ratio (aOR) and the corresponding 95% confidence interval (CI) for PTB among different maternal age groups. Analyses were separately performed according to type of pregnancy (singletons and multiples). Reference group was the age group with the lowest frequency of PTB. Results Overall, 49,759 (6.6%) PTBs were observed, of which 41,807 were singletons and 7952 were multiples. Rates of PTB were lowest in the women aged 25–29 years among singletons and in the 30–34 years old group among multiples. Our results described a U-shaped association between maternal age and risk of PTB. In particular, the risk of a singleton PTB between 32 and 36 weeks was significantly higher for women aged less than 20 years (aOR = 1.16, CI 95%: 1.04–1.30) and more than 40 years (aOR = 1.62 CI 95%: 1.54–1.70). The highest risk of a multiple delivery between 32 and 36 weeks was observed among women aged less than 25 years and more than 40 years (aOR = 1.79, CI 95%: 1.01–3.17, aOR = 1.47, CI 95%: 1.16–1.85 and aOR = 1.36, CI 95%: 1.19–1.55 respectively for < 20, 20–24 and > 40 age categories). PTB before 32 completed weeks occurred more frequently in the same age categories, except that among multiples no association with advanced maternal age emerged. Conclusion Our study suggested that, after adjustment for potential confounders, both advance and young maternal age were associated with an increased risk of PTB.

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Re: Moore EK, Irvine LM. 2014. The impact of maternal age over forty years on the caesarean section rate: six year experience at a busy district general hospital. Journal of Obstetrics and Gynaecology 34:238–240

Cited by 2 publications

References 5 publications

Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study

Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study

The role of maternal age on the risk of preterm birth among singletons and multiples: a retrospective cohort study in Lombardy, Northern Italy

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