Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study
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 m...
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| Veröffentlicht in: | Acta obstetricia et gynecologica Scandinavica 2020-02, Vol.99 (2), p.283-289 |
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| creator | 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. |
| description | 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. |
| doi_str_mv | 10.1111/aogs.13743 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2301429938</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2340167760</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5743-b82ac0d7dee6698fe9d4656c49dd916c4bc4956a4be32884fb7d357357b15a8b3</originalsourceid><addsrcrecordid>eNqNkstu1DAUhiMEomVgwwOAJTYINMWOHcdZjkZQkAa6ANaWLyeD20w8jRONZtdHYMET9kk46VyQkIqI4vii7_9zjvxn2XNGzxg-70xcpjPGS8EfZKdMUjqlguUPs1NKKZtKLqqT7ElKl7jLS6EeZyecFYrLSpxm8bPpoWtNQ8wSiGk96UK6IrEmDpLpwLQkgetDbEloySauAL-h_4E7PzjwpDE2dsT0BG1Wtze_ZuRL7HxwpINlSHh4e_PTmoRk6ge_fZo9qk2T4Nl-nmTfP7z_Nv84XVycf5rPFlNXYB9Tq3LjqC89gJSVqqHyQhbSicr7iuFscVlIIyzwXClR29LzosTXssIoyyfZdOebNrAerF53YWW6rY4m6P3RFa5Ai1JKmiNf3cuvu-j_iA5CJnIuJMtH7eJebTOscVgcdxomlFU-1zWVTAtfF9pi8Zo7ATWvufTYwyR7ubNzeBV9aHUbO6MZpbzUTLGCIvF6R2Bl1wOkXq9CctA0poU4JJ1zitVVFVeIvvoLvYzDeN8jJSiTZSlHwzeHX8aUOqiPPTCqx4zpMWP6LmMIv9hbDnYF_ogeQoWA2gEbsLFOLkDr4IhhKEWlOM0LOuZzHnozxmseh7ZH6dv_lyLN9nRoYPuPmvXs4vzrrvrf-jP98A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2340167760</pqid></control><display><type>article</type><title>Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study</title><source>MEDLINE</source><source>NORA - Norwegian Open Research Archives</source><source>SWEPUB Freely available online</source><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>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.</creator><creatorcontrib>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.</creatorcontrib><description>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.</description><identifier>ISSN: 0001-6349</identifier><identifier>ISSN: 1600-0412</identifier><identifier>EISSN: 1600-0412</identifier><identifier>DOI: 10.1111/aogs.13743</identifier><identifier>PMID: 31583694</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>Adult ; Age ; birth register ; Cesarean section ; Cesarean Section - statistics & numerical data ; Clinical medical disciplines: 750 ; Clinical Medicine ; Female ; Gynecology and obstetrics: 756 ; Gynekologi og obstetrikk: 756 ; Health risk assessment ; Health risks ; Humans ; Induced labor ; induction of labor ; Klinisk medicin ; Klinisk medisinske fag: 750 ; Labor, Induced ; Life Sciences & Biomedicine ; Maternal Age ; Medical and Health Sciences ; Medical disciplines: 700 ; Medicin och hälsovetenskap ; Medisinske Fag: 700 ; Obstetrics & Gynecology ; Obstetrics, Gynecology and Reproductive Medicine ; Pregnancy ; Pregnancy Outcome ; Registries ; Reproduktionsmedicin och gynekologi ; Retrospective Studies ; Risk Factors ; Scandinavian and Nordic Countries ; Science & Technology ; VDP ; Womens health</subject><ispartof>Acta obstetricia et gynecologica Scandinavica, 2020-02, Vol.99 (2), p.283-289</ispartof><rights>2019 Nordic Federation of Societies of Obstetrics and Gynecology</rights><rights>2019 Nordic Federation of Societies of Obstetrics and Gynecology.</rights><rights>Copyright © 2020 Acta Obstetricia et Gynecologica Scandinavica</rights><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>30</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000498302500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c5743-b82ac0d7dee6698fe9d4656c49dd916c4bc4956a4be32884fb7d357357b15a8b3</citedby><cites>FETCH-LOGICAL-c5743-b82ac0d7dee6698fe9d4656c49dd916c4bc4956a4be32884fb7d357357b15a8b3</cites><orcidid>0000-0002-7284-6094 ; 0000-0003-4149-5663 ; 0000-0001-5765-2630 ; 0000-0001-9968-6660 ; 0000-0001-9875-4991 ; 0000-0001-8254-7525</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faogs.13743$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faogs.13743$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,554,782,786,887,1419,26574,27931,27932,28255,45581,45582</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31583694$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/1148b8d2-f061-4df5-b84f-3c4ef3f36d57$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:142346122$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Bergholt, Thomas</creatorcontrib><creatorcontrib>Skjeldestad, Finn E.</creatorcontrib><creatorcontrib>Pyykönen, Aura</creatorcontrib><creatorcontrib>Rasmussen, Steen C.</creatorcontrib><creatorcontrib>Tapper, Anna‐Maija</creatorcontrib><creatorcontrib>Bjarnadóttir, Ragnheiður I.</creatorcontrib><creatorcontrib>Smárason, Alexander</creatorcontrib><creatorcontrib>Másdóttir, Birna B.</creatorcontrib><creatorcontrib>Klungsøyr, Kari</creatorcontrib><creatorcontrib>Albrechtsen, Susanne</creatorcontrib><creatorcontrib>Källén, Karin</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Løkkegaard, Ellen C. L.</creatorcontrib><title>Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study</title><title>Acta obstetricia et gynecologica Scandinavica</title><addtitle>ACTA OBSTET GYN SCAN</addtitle><addtitle>Acta Obstet Gynecol Scand</addtitle><description>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.</description><subject>Adult</subject><subject>Age</subject><subject>birth register</subject><subject>Cesarean section</subject><subject>Cesarean Section - statistics & numerical data</subject><subject>Clinical medical disciplines: 750</subject><subject>Clinical Medicine</subject><subject>Female</subject><subject>Gynecology and obstetrics: 756</subject><subject>Gynekologi og obstetrikk: 756</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Induced labor</subject><subject>induction of labor</subject><subject>Klinisk medicin</subject><subject>Klinisk medisinske fag: 750</subject><subject>Labor, Induced</subject><subject>Life Sciences & Biomedicine</subject><subject>Maternal Age</subject><subject>Medical and Health Sciences</subject><subject>Medical disciplines: 700</subject><subject>Medicin och hälsovetenskap</subject><subject>Medisinske Fag: 700</subject><subject>Obstetrics & Gynecology</subject><subject>Obstetrics, Gynecology and Reproductive Medicine</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Registries</subject><subject>Reproduktionsmedicin och gynekologi</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Scandinavian and Nordic Countries</subject><subject>Science & Technology</subject><subject>VDP</subject><subject>Womens health</subject><issn>0001-6349</issn><issn>1600-0412</issn><issn>1600-0412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>3HK</sourceid><sourceid>D8T</sourceid><recordid>eNqNkstu1DAUhiMEomVgwwOAJTYINMWOHcdZjkZQkAa6ANaWLyeD20w8jRONZtdHYMET9kk46VyQkIqI4vii7_9zjvxn2XNGzxg-70xcpjPGS8EfZKdMUjqlguUPs1NKKZtKLqqT7ElKl7jLS6EeZyecFYrLSpxm8bPpoWtNQ8wSiGk96UK6IrEmDpLpwLQkgetDbEloySauAL-h_4E7PzjwpDE2dsT0BG1Wtze_ZuRL7HxwpINlSHh4e_PTmoRk6ge_fZo9qk2T4Nl-nmTfP7z_Nv84XVycf5rPFlNXYB9Tq3LjqC89gJSVqqHyQhbSicr7iuFscVlIIyzwXClR29LzosTXssIoyyfZdOebNrAerF53YWW6rY4m6P3RFa5Ai1JKmiNf3cuvu-j_iA5CJnIuJMtH7eJebTOscVgcdxomlFU-1zWVTAtfF9pi8Zo7ATWvufTYwyR7ubNzeBV9aHUbO6MZpbzUTLGCIvF6R2Bl1wOkXq9CctA0poU4JJ1zitVVFVeIvvoLvYzDeN8jJSiTZSlHwzeHX8aUOqiPPTCqx4zpMWP6LmMIv9hbDnYF_ogeQoWA2gEbsLFOLkDr4IhhKEWlOM0LOuZzHnozxmseh7ZH6dv_lyLN9nRoYPuPmvXs4vzrrvrf-jP98A</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Bergholt, Thomas</creator><creator>Skjeldestad, Finn E.</creator><creator>Pyykönen, Aura</creator><creator>Rasmussen, Steen C.</creator><creator>Tapper, Anna‐Maija</creator><creator>Bjarnadóttir, Ragnheiður I.</creator><creator>Smárason, Alexander</creator><creator>Másdóttir, Birna B.</creator><creator>Klungsøyr, Kari</creator><creator>Albrechtsen, Susanne</creator><creator>Källén, Karin</creator><creator>Gissler, Mika</creator><creator>Løkkegaard, Ellen C. L.</creator><general>Wiley</general><general>John Wiley & Sons, Inc</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>3HK</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D95</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-7284-6094</orcidid><orcidid>https://orcid.org/0000-0003-4149-5663</orcidid><orcidid>https://orcid.org/0000-0001-5765-2630</orcidid><orcidid>https://orcid.org/0000-0001-9968-6660</orcidid><orcidid>https://orcid.org/0000-0001-9875-4991</orcidid><orcidid>https://orcid.org/0000-0001-8254-7525</orcidid></search><sort><creationdate>202002</creationdate><title>Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5743-b82ac0d7dee6698fe9d4656c49dd916c4bc4956a4be32884fb7d357357b15a8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Age</topic><topic>birth register</topic><topic>Cesarean section</topic><topic>Cesarean Section - statistics & numerical data</topic><topic>Clinical medical disciplines: 750</topic><topic>Clinical Medicine</topic><topic>Female</topic><topic>Gynecology and obstetrics: 756</topic><topic>Gynekologi og obstetrikk: 756</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Humans</topic><topic>Induced labor</topic><topic>induction of labor</topic><topic>Klinisk medicin</topic><topic>Klinisk medisinske fag: 750</topic><topic>Labor, Induced</topic><topic>Life Sciences & Biomedicine</topic><topic>Maternal Age</topic><topic>Medical and Health Sciences</topic><topic>Medical disciplines: 700</topic><topic>Medicin och hälsovetenskap</topic><topic>Medisinske Fag: 700</topic><topic>Obstetrics & Gynecology</topic><topic>Obstetrics, Gynecology and Reproductive Medicine</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Registries</topic><topic>Reproduktionsmedicin och gynekologi</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Scandinavian and Nordic Countries</topic><topic>Science & Technology</topic><topic>VDP</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bergholt, Thomas</creatorcontrib><creatorcontrib>Skjeldestad, Finn E.</creatorcontrib><creatorcontrib>Pyykönen, Aura</creatorcontrib><creatorcontrib>Rasmussen, Steen C.</creatorcontrib><creatorcontrib>Tapper, Anna‐Maija</creatorcontrib><creatorcontrib>Bjarnadóttir, Ragnheiður I.</creatorcontrib><creatorcontrib>Smárason, Alexander</creatorcontrib><creatorcontrib>Másdóttir, Birna B.</creatorcontrib><creatorcontrib>Klungsøyr, Kari</creatorcontrib><creatorcontrib>Albrechtsen, Susanne</creatorcontrib><creatorcontrib>Källén, Karin</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Løkkegaard, Ellen C. L.</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Lunds universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bergholt, Thomas</au><au>Skjeldestad, Finn E.</au><au>Pyykönen, Aura</au><au>Rasmussen, Steen C.</au><au>Tapper, Anna‐Maija</au><au>Bjarnadóttir, Ragnheiður I.</au><au>Smárason, Alexander</au><au>Másdóttir, Birna B.</au><au>Klungsøyr, Kari</au><au>Albrechtsen, Susanne</au><au>Källén, Karin</au><au>Gissler, Mika</au><au>Løkkegaard, Ellen C. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study</atitle><jtitle>Acta obstetricia et gynecologica Scandinavica</jtitle><stitle>ACTA OBSTET GYN SCAN</stitle><addtitle>Acta Obstet Gynecol Scand</addtitle><date>2020-02</date><risdate>2020</risdate><volume>99</volume><issue>2</issue><spage>283</spage><epage>289</epage><pages>283-289</pages><issn>0001-6349</issn><issn>1600-0412</issn><eissn>1600-0412</eissn><abstract>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.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>31583694</pmid><doi>10.1111/aogs.13743</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7284-6094</orcidid><orcidid>https://orcid.org/0000-0003-4149-5663</orcidid><orcidid>https://orcid.org/0000-0001-5765-2630</orcidid><orcidid>https://orcid.org/0000-0001-9968-6660</orcidid><orcidid>https://orcid.org/0000-0001-9875-4991</orcidid><orcidid>https://orcid.org/0000-0001-8254-7525</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Acta obstetricia et gynecologica Scandinavica, 2020-02, Vol.99 (2), p.283-289 |
| issn | 0001-6349 1600-0412 1600-0412 |
| language | eng |
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| source | MEDLINE; NORA - Norwegian Open Research Archives; SWEPUB Freely available online; Access via Wiley Online Library; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Adult Age birth register Cesarean section Cesarean Section - statistics & numerical data Clinical medical disciplines: 750 Clinical Medicine Female Gynecology and obstetrics: 756 Gynekologi og obstetrikk: 756 Health risk assessment Health risks Humans Induced labor induction of labor Klinisk medicin Klinisk medisinske fag: 750 Labor, Induced Life Sciences & Biomedicine Maternal Age Medical and Health Sciences Medical disciplines: 700 Medicin och hälsovetenskap Medisinske Fag: 700 Obstetrics & Gynecology Obstetrics, Gynecology and Reproductive Medicine Pregnancy Pregnancy Outcome Registries Reproduktionsmedicin och gynekologi Retrospective Studies Risk Factors Scandinavian and Nordic Countries Science & Technology VDP Womens health |
| title | Maternal age and risk of cesarean section in women with induced labor at term—A Nordic register‐based study |
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