Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register-based study
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Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register-based study. / Bergholt, Thomas; Skjeldestad, Finn E.; Pyykönen, Aura; Rasmussen, Steen C.; Tapper, Anna Maija; Bjarnadóttir, Ragnheiður I.; Smárason, Alexander; Másdóttir, Birna B.; Klungsøyr, Kari; Albrechtsen, Susanne; Källén, Karin; Gissler, Mika; Løkkegaard, Ellen C.L.
I: Acta Obstetricia et Gynecologica Scandinavica, Bind 99, Nr. 2, 2020, s. 283-289.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register-based study
AU - Bergholt, Thomas
AU - Skjeldestad, Finn E.
AU - Pyykönen, Aura
AU - Rasmussen, Steen C.
AU - Tapper, Anna Maija
AU - Bjarnadóttir, Ragnheiður I.
AU - Smárason, Alexander
AU - Másdóttir, Birna B.
AU - Klungsøyr, Kari
AU - Albrechtsen, Susanne
AU - Källén, Karin
AU - Gissler, Mika
AU - Løkkegaard, Ellen C.L.
PY - 2020
Y1 - 2020
N2 - Introduction: Over the last decades, induction of labor has increased in many countries along with increasing maternal age. We assessed the effects of maternal age and labor induction on cesarean section at term among nulliparous and multiparous women without previous cesarean section. Material and methods: We performed a retrospective national registry-based study from Denmark, Finland, Iceland, Norway, and Sweden including 3 398 586 deliveries between 2000 and 2011. We investigated the impact of age on cesarean section among 196 220 nulliparous and 188 158 multiparous women whose labor was induced, had single cephalic presentation at term, and no previous cesarean section. Confounders comprised country, time-period, and gestational age. Results: In nulliparous women with induced labor the rate of cesarean section increased from 14.0% in women less than 20 years of age to 39.9% in women 40 years and older. Compared with women aged 25-29 years, the corresponding relative risks were 0.60 (95% confidence interval [95% CI] 0.57 to 0.64) and 1.72 (95% CI 1.66 to 1.79). In multiparous induced women the risk of cesarean section was 3.9% in women less than 20 years rising to 9.1% in women 40 years and older. Compared with women aged 25-29 years, the relative risks were 0.86 (95% CI 0.54 to 1.37) and 1.98 (95% CI 1.84 to 2.12), respectively. There were minimal confounding effects of country, time-period, and gestational age on risk for cesarean section. Conclusions: Advanced maternal age is associated with increased risk of cesarean section in women undergoing labor induction with a single cephalic presentation at term without a previous cesarean section. The absolute risk of cesarean section is 3-5 times higher across 5-year age groups in nulliparous relative to multiparous women having induced labor.
AB - Introduction: Over the last decades, induction of labor has increased in many countries along with increasing maternal age. We assessed the effects of maternal age and labor induction on cesarean section at term among nulliparous and multiparous women without previous cesarean section. Material and methods: We performed a retrospective national registry-based study from Denmark, Finland, Iceland, Norway, and Sweden including 3 398 586 deliveries between 2000 and 2011. We investigated the impact of age on cesarean section among 196 220 nulliparous and 188 158 multiparous women whose labor was induced, had single cephalic presentation at term, and no previous cesarean section. Confounders comprised country, time-period, and gestational age. Results: In nulliparous women with induced labor the rate of cesarean section increased from 14.0% in women less than 20 years of age to 39.9% in women 40 years and older. Compared with women aged 25-29 years, the corresponding relative risks were 0.60 (95% confidence interval [95% CI] 0.57 to 0.64) and 1.72 (95% CI 1.66 to 1.79). In multiparous induced women the risk of cesarean section was 3.9% in women less than 20 years rising to 9.1% in women 40 years and older. Compared with women aged 25-29 years, the relative risks were 0.86 (95% CI 0.54 to 1.37) and 1.98 (95% CI 1.84 to 2.12), respectively. There were minimal confounding effects of country, time-period, and gestational age on risk for cesarean section. Conclusions: Advanced maternal age is associated with increased risk of cesarean section in women undergoing labor induction with a single cephalic presentation at term without a previous cesarean section. The absolute risk of cesarean section is 3-5 times higher across 5-year age groups in nulliparous relative to multiparous women having induced labor.
KW - birth register
KW - cesarean section
KW - induction of labor
KW - maternal age
U2 - 10.1111/aogs.13743
DO - 10.1111/aogs.13743
M3 - Journal article
C2 - 31583694
AN - SCOPUS:85075424377
VL - 99
SP - 283
EP - 289
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 2
ER -
ID: 236022178