The association of fetal sex with the rate of cesarean section

“…Those findings support the conclusion of Lau et al [13] that male fetuses are at higher risk of developing fetal distress during labor. Lieberman et al [14] found a 70% increase in cesarean deliveries for fetal distress in women carrying male fetuses (OR = 1.7; 95% CI 1.0-3.0). Moreover, male infants delivered by CS for fetal distress also had lower Apgar scores than female fetuses delivered for the same indication.…”

Section: Discussionmentioning

confidence: 99%

Gender Does Matter in Perinatal Medicine

Sheiner¹,

Levy

Katz³

et al. 2004

Fetal Diagn Ther

153

114

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Objective: To investigate complications and outcome of pregnancies with male and female fetuses. Methods: A population-based study comparing all singleton deliveries between the years 1988 and 1999 was performed. We compared pregnancies with male vs. female fetuses. Patients with a previous cesarean section (CS) were excluded from the study. Statistical analyses with the Mantel-Haenszel technique and multiple logistic regression models were performed to control for confounders. Results: During the study period there were 55,891 deliveries of male and 53,104 deliveries of female neonates. Patients carrying male fetuses had higher rates of gestational diabetes mellitus (OR = 1.1; 95% CI 1.01–1.12; p = 0.012), fetal macrosomia (OR = 2.0; 95% CI 1.8–2.1; p < 0.001), failure to progress during the first and second stages of labor (OR = 1.2; 95% CI 1.1–1.3; p < 0.001 and OR = 1.4; 95% CI 1.3–1.5; p < 0.001, respectively), cord prolapse (OR = 1.3; 95% CI 1.1–1.6; p = 0.014), nuchal cord (OR = 1.2; 95% CI 1.1–1.2; p < 0.001) and true umbilical cord knots (OR = 1.5; 95% CI 1.3–1.7; p < 0.001). Higher rates of CS were found among male compared with female neonates (8.7 vs. 7.9%; OR = 1.1; 95% CI 1.06–1.16; p < 0.001). Using three multivariate logistic regression models and controlling for birth weight and gestational age, male gender was significantly associated with non-reassuring fetal heart rate patterns (OR = 1.5; 95% CI 1.4–1.6; p < 0.001), low Apgar scores at 5 min (OR = 1.5; 95% CI 1.3–1.8; p < 0.001) and CS (OR = 1.2; 95%CI 1.2–1.3; p < 0.001). Controlling for possible confounders like gestational diabetes, cord prolapse, failed induction, nonprogressive labor, fetal macrosomia, nuchal cord and true umbilical cord knots using the Mantel-Haenszel technique did not change the significant association between male gender and CS. Conclusion: Male gender is an independent risk factor for adverse pregnancy outcome.

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“…Lieberman'ın çalışmasın-da sezaryen oranı erkeklerde %13,2 kızlarda %9,6 bulunmuş, bu %30'luk farkta erkek cinsiyetin sezaryen için öngörülen bir risk olmadığı fakat sezaryen ile doğan bebeklerde doğum sonrası 3 kat fazla fetal distress görüldüğü saptanmıştır (8 4 çok yakın değilse sezaryen tercih edilir. Fetüsün ölü olduğu durumlarda kanama, hemodinamiyi bozacak kadar ağır değilse ve vajinal doğum yapmayı engelleyecek başka bir obstetrik neden yok ise vajinal doğum yapılabilir.…”

Section: Yöntemlerunclassified

Investigation of Cesarean Sections at Istanbul Training and Research Hospital Obstetrics and Gynecology Department between 2005 and 2012

Uzunçakmak¹,

Güldaş²,

Aydin³

et al. 2013

Istanbul Med J

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Amaç: Çalışmamızda 2005-2012 yılları arasındaki sezaryenlerin yıllara göre dağılımını, sezaryen endikasyonlarını ve epidemiyolojik değişimleri karşı-laştırarak, geleceğe yönelik yapılması gerekenleri tartışmak amaçlanmıştır.Yöntemler: İstanbul Eğitim Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği'nde 2005-2012 yılları arasındaki 10499 doğum içinden sezaryen uygulanan 4137 hastanın dosyaları retrospektif olarak incelendi. Yılla-ra göre sezaryenle doğum yapmış hastalar sezaryen endikasyonlarına, yaş gruplarına, gebelik haftalarına, doğum ağırlıklarına, bebek cinsiyetlerine, sezaryende tercih edilen anestezi türüne ve sezaryenin normal doğuma oranlarına göre yıllık bazda değerlendirildi ve karşılaştırıldı. Results: Cesarean section was performed for 32.5% and 40.1% patients in 2005 and 2012, respectively. The main indications were previous uterine surgery (44.5%), fetal distress (18.3%) and cephalopelvic disproportion (33.7%). There was no statistical difference in terms of gravida, parity, anesthesia, and birth weight in either year. However, cesarean rates were significantly increased in the last four years of the study period in comparison with the first four years. Conclusion:Rates of caesarean section are increasing. To counteract this trend, patients should be informed about the benefits of vaginal delivery and be encouraged to attempt vaginal delivery after cesarean section now that the skills of staff in delivery clinics are improving. Clinicians and patients must be aware of side effects of elective cesarean sections. Pain management during delivery may be considered as a means of reversing the increasing cesarean rates.

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The association of fetal sex with the rate of cesarean section

Cited by 81 publications

References 12 publications

Intrauterine Foetal Death and Its Probable Causes: Two Years Experience in Dhulikhel Hospital – Kathmandu University Hospital

Intrauterine Foetal Death and Its Probable Causes: Two Years Experience in Dhulikhel Hospital – Kathmandu University Hospital

Gender Does Matter in Perinatal Medicine

Investigation of Cesarean Sections at Istanbul Training and Research Hospital Obstetrics and Gynecology Department between 2005 and 2012

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