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Rate of Planned C-Section on Maternal Request Stable in Canada

MONDAY, May 3, 2021 -- Rates of planned cesarean delivery on maternal request (CDMR) have remained stable in Canada, and planned CDMR may be associated with a reduced risk for short-term adverse outcomes, according to a study published in the May 3 issue of CMAJ, the journal of the Canadian Medical Association.

Yanfang Guo, Ph.D., from Better Outcomes Registry & Network Ontario in Ottawa, Canada, and colleagues designed a population-based retrospective cohort study using data on low-risk pregnancies in Ontario from April 2012 to March 2018 to examine temporal trends and determinants of CDMR.

Data were included for 422,210 women, of whom 0.4 and 99.6 percent had a planned CDMR and a planned vaginal delivery, respectively. The researchers found that over time, the prevalence of CDMR remained stable, at 3.9 percent of all cesarean deliveries. Late maternal age, higher education, conception via in vitro fertilization, anxiety, nulliparity, being White, delivery at a hospital providing higher levels of maternal care, and obstetrician-based antenatal care were associated with CDMR. Compared with women who planned vaginal delivery, women who planned CDMR had a lower risk for adverse outcomes (adjusted relative risk, 0.42) and a lower Weighted Adverse Outcome Score (mean difference, −1.28). There was no statistically significant between-group difference in the Severity Index.

"Although our study addresses concerns related to the immediate implications of planned CDMR, exploration of longer-term risks is needed, including its impact on breastfeeding, and the child's risk for infection and respiratory illness," the authors write.

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