Abstract

OLIVEIRA, Joana; TAVARES, Sara; MONTENEGRO, Nuno  and  RAMALHO, Carla. Influence of maternal age on caesarean delivery: experience in a tertiary hospital. Acta Obstet Ginecol Port [online]. 2018, vol.12, n.2, pp.99-104. ISSN 1646-5830.

Caesarian section (C-section) is a worrisome issue due to its increasing incidence and associated risks, especially in low risk pregnancies. Maternal age has an increasing tendency in modern societies and appears to be contributing to the rise in the Csection rates - due to co-morbidities, "high risk labeling" or an intrinsic biological cause related to aging. Our aim is to evaluate the association between maternal age and delivery mode in low risk pregnancies. Retrospective observational study using electronic medical records, ICD-9-CM coding system and unit database software Obscare. Data from low risk singleton term labors occurred from January 2008 to December 2012 was included. We assessed 10411 cases, divided in three age groups (<20, 20-34, ≥35 years old) - women with 20 to 34 years old were considered the reference group. Parity, presentation, delivery mode, induction, C-section indication and timing were assessed. Women with ≥35 years old have a higher probability of C-section, 30.7% vs. 22.3%, OR 1.527 [1.371-1.700]. This odd remains higher in non-induced labors, OR 1.367 [1.221-1.531], but loses its significance in the subset of only induced labors. In both multiparous and nulliparous the probability of C-section remains higher for women >35 years old, OR 1.581 [1.356-1.843] and 2.098 [1.742-2.527]. This age group has a higher probability of having a C-section due to "previous C-section" OR 3.121 [2.519-3.865], and a lower probability due to "labor arrest" and "non-reassuring fetal tracing", OR .559 [.457-.685] and .724 [.563-.931], respectively. For the older group, the odd of having an elective C-section was higher, OR 1.844 [1.509-2.254] and of having an urgent C-section lower, OR, .644 [.537-.774]. Older women have a higher probability of having a C-section, even in the absence of identifiable comorbidities. Elective interventions and previous C-sections seem to play a crucial role in this association.

Keywords : Delivery; Obstetric; Cesarean Section; Maternal age.

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