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.2022 Dec 30;20(1):668.
doi: 10.3390/ijerph20010668.

Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study

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Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study

Anna Šťastná et al. Int J Environ Res Public Health..

Abstract

Objective: To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics.

Methods: Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children).

Results: An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54-1.71) to 1.84 (95% CI 1.70-1.99) for age group 35-39 and OR: 2.83 (95% CI 2.60-3.08) to 3.71 (95% CI 3.23-4.27) for age group 40+ compared to age group 25-29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35-39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80-0.91) to 0.87 (95% CI 0.83-0.91) for tertiary-educated compared to secondary-educated women.

Conclusions: The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.

Keywords: Czechia; caesarean section (CS); education; fertility postponement; marital status; maternal age.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Share of CS births (in %) and index of the change in the share of CS births between 1994 and 2018, Czechia. Source: IHIS 2000, 2015, 2018. Authors’ own calculations.
Figure 2
Figure 2
Probability of a CS by maternal age and parity, all deliveries, Czechia, 2018. Based on the results of Model 2, which was adjusted for gestational age, singleton/multiple deliveries, previous CS delivery, ART usage, the incidence of diabetes, health complications in pregnancy, and breech position.
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