Caesarean delivery associated with higher risk of serious complications for the mother

Caesarean delivery is badociated with a higher risk of serious complications in the mother compared to badl delivery, especially in women aged 35 and older, according to new research published in CMAJ (Journal of the Canadian Medical Association).

"These results have implications for clinical practice and will be helpful in deciding on the type of delivery," says Dr. Diane Korb, Obstetrician and Epidemiologist at Robert Debré Hospital and INSERM, at Paris, France. "Physicians need to consider this increased risk to determine the best way to deliver, especially for older mothers."

Caesarean delivery rates have increased dramatically over the last 20 years, with more than one in five women delivering by cesarean section, often for medically dubious reasons.

Although there are observational studies on cesarean deliveries, the results can be influenced – and can be confused – by the condition requiring caesarean section rather than by the surgical procedure itself.

"Maternal complications may be the result of the condition that led to caesarean delivery rather than the surgical procedure, producing an apparent badociation between cesarean delivery and maternal complications," said the Dr. Korb.

To understand whether cesarean deliveries are badociated with severe maternal complications, French researchers used a sub-cohort of a larger study (EPIMOMS study) to compare 1,444 women who had serious complications after birth. delivery to 3,464 controls that had no complications in 6 French regions. They monitored factors that could influence results and adjusted for baseline risk. They excluded women with pre-existing health problems that could lead to complications.

Researchers have found an increased likelihood of serious postpartum complications in women who delivered by caesarean section whether surgery is performed before or during labor, especially for women aged 35 and over. Although serious maternal complications are generally rare, the study found that, in women under 35, the risk of serious complications in women delivered by caesarean section was about 1.5 times higher than that of women who gave birth by birth. badlly, while women over 35 years of age were almost twice as likely. The most serious maternal complications involved haemorrhage after delivery; the ability of the uterus to contract decreases with advanced maternal age.

"Our findings raise questions about the practices of some obstetricians performing caesarean deliveries because of their advanced maternal age, possibly with the thought that there will likely be no future pregnancy." ", says Dr. Korb. "This practice should be modified to avoid unnecessarily exposing women over 35 years of age to the risk of severe acute maternal morbidity."

"The risk of severe maternal morbidity related to caesarean section and the role of the mother's age: badysis of the propensity score in population" is published on April 1, 2019.

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Journal of the Canadian Medical Association