The Effect of Pelvic Size on Cesarean Delivery Rates: Using Adolescent Maternal Age as an Unbiased Proxy for Pelvic Size

Labor and delivery outcomes among young adolescents

“…Our finding that adolescents aged 11-14 years had a decreased risk of cesarean delivery is largely supported by the literature, 11,14,15 although some studies report conflicting data. 13 A populationbased study of Swedish women demonstrated a decreased risk of cesarean delivery in women <16 years of age compared with those aged 20-30 years. 15 Similarly, a large database study of 37 million US women demonstrated lower cesarean risk in adolescents age <15 years compared with all women age >15 years.…”

“…11 Another study published using the same large dataset of US women reported an elevated risk of cesarean delivery in women aged 12-14 years compared with those aged 15-20 years, but this finding was limited to women with normal-weight or macrosomic neonates. 13 Our analysis, in contrast, adjusted for birthweight in comparing vaginal to cesarean deliveries and spontaneous vaginal to operative vaginal deliveries. Authors reporting an increased risk of cesarean delivery in women age <15 years have cited cephalopelvic disproportion as a potential etiology.…”

“…11 It has been hypothesized that adolescents <15 years of age may have an increased risk of cesarean and operative vaginal delivery compared to adult women, possibly due to cephalopelvic disproportion resulting from underdeveloped bone structures. 12,13 Multiple large database studies have demonstrated a decreased risk of cesarean delivery among teens 5,11,14,15 ; however, many of these studies have used samples composed primarily of adolescents age 16 years, with fewer young adolescents represented. One study among young adolescents <15 years-old, specifically, found an increased risk of cesarean, although the effect was limited to those with normal-weight or macrosomic infants.…”

“…One study among young adolescents <15 years-old, specifically, found an increased risk of cesarean, although the effect was limited to those with normal-weight or macrosomic infants. 13 Two studies suggest an increased risk of birth trauma in the youngest adolescents, with higher risk of emergency cesarean delivery, perineal trauma, 16 and forceps-assisted delivery 7 compared to older teens with infants at comparable birthweight and gestational age. As few population-based studies have reported birth outcomes among young adolescents, we used data from Washington State to investigate method of delivery, including cesarean and operative vaginal delivery, and maternal and neonatal delivery complications among adolescents aged 11-14 years, young teens aged 15-17 years, and older teens aged 18-19 years compared to young adults aged 20-24 years.…”

Maternity in adolescents and its association with caesarean labor

“…The main route was vaginal delivery for both cases to controls, no statistically significant difference between the two; there wasn `t a significant difference between cesarean section in adolescents and young adults (32.8 vs. 36.9%) was observed. By comparing these data with recent studies are divergences (5,10,12,18,19). For example, the study by Malaberey et al (18) analyzed a cohort of 6,188,704 cases over a period of 10 years and suggests that adolescents have increased rates of cesarean section, especially those under 12, in whom the immaturity of the pelvis and is the disproportion cephalopelvic main indication for termination of pregnancy by high way, which has been shown in other studies (12,20).…”