High CD rates tied to changing patient characteristics

  • BMC Pregnancy Childbirth

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Risk factors for labor dystocia resulting in cesarean delivery (CD) are defined. 

Why this matters

  • Worldwide efforts are ongoing to understand and reduce high CD rate.
  • Preconception counseling, as opposed to increased scrutiny of physicians during labor, may help reduce CD rates.

Key results

  • Independent risk factors for CD:
    • Higher BMI: 24.1 vs 22.6 kg/m2, P<.001>
    • Advanced maternal age: 28.9 vs 27.3 years, P<.001>
    • Longer gestational age: 285 vs 281 days, P<.001>
    • Less advanced cervical status at admission: 1.5 vs 2.6 cm, P<.001>
    • Chorioamnionitis: 95 vs 10, P<.001 and>
    • Fetal malposition: 148 vs 7, P<.001.>
  • 94% of newborns whose weight was >4500 g were delivered by CD.
  • BMI affected risk for premature rupture of membranes:
    • 41.9% with severe obesity,
    • 27.6% with overweight, and
    • 13.6% with normal weight; P=.046.
  • No group differences observed in neonatal outcomes.

Study design

  • Retrospective, parity-matched, case-control study.
  • Cohort obtained from medical records of a tertiary delivery unit between 2009 and 2012.
  • Primiparous women who had a term CD as a result of dystocia (n=296) were compared with control participants (n=302).
  • Maternal and neonatal characteristics were compared.
  • Funding: Orion Research Foundation; Government of Finland. 

Limitations

  • Study could not control for indication for CD.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit