Cesarean Delivery May Up Risk for Severe Maternal Morbidity
TUESDAY, April 2, 2019 -- Cesarean delivery is associated with an increased risk for severe maternal morbidity, according to a study published online April 1 in CMAJ, the journal of the Canadian Medical Association.
Diane Korb, M.D., M.P.H., from the Paris Descartes University, and colleagues compared cases of intrapartum or postpartum severe acute maternal morbidity to controls randomly selected using data from EPIMOMS, the prospective population-based study of deliveries at 22 gestation weeks or later from six regions in France in 2012 to 2013. In a propensity score-matched sample, the authors estimated associations between delivery modes and severe acute maternal morbidity.
The researchers identified 1,444 cases and 3,464 controls among 182,300 deliveries. A significantly greater proportion of cesarean deliveries was seen among cases versus controls (36.0 versus 18.2 percent). Cesarean deliveries correlated with a higher risk for severe acute maternal morbidity in the propensity score-matched analysis (adjusted odds ratio, 1.8). This correlation increased with maternal age and was stronger for women aged 35 years or older (adjusted odds ratio, 2.9).
"Our finding raises questions about the practices of some obstetricians who may consider cesarean deliveries to be indicated by advanced maternal age, with the idea that there will probably be no further pregnancies," the authors write. "This practice should be modified to avoid unnecessarily exposing women older than 35 years to the excess risk of severe acute maternal morbidity."
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Posted: April 2019