A new French study reveals that cesarean delivery is associated with an increased risk of serious complications for the mother, especially for women 35 years of age or older.
A French cesarean study, published in the Canadian Medical Association Journal, was based on a larger study sub-cohort (EPIMOMS) and compared 1,444 women who had serious complications after childbirth with a control group of 3,464 women.
The researchers considered factors that could affect outcomes and excluded women who had pre-delivery health problems that could have caused these complications.
Double the risk after 35 years
The study found that for women under 35 the probability of having maternal complications after cesarean delivery was about 1.5 times higher than those who had normal delivery. This probability was nearly twice as high among women over 35 years of age.
"These findings have implications for clinical practice and will be useful in deciding the type of delivery, and physicians need to consider this increased risk to determine the best way to administer it, especially for older mothers," the report said. Lead author Diane Korb, obstetrician at Robert Debré Hospital and epidemiologist at Inserm (Paris).
Questions about the practices of some obstetricians
Most of the serious maternal complications of cesarean section involved postpartum haemorrhage. "Our results raises questions about the practices of some obstetricians who perform cesarean deliveries because of their mother's advanced age, perhaps with the idea that there will probably be no other pregnancies.
"This practice should be changed to avoid unnecessary exposure of women over the age of 35 to the risk of severe acute maternal morbidity," warns Diane Korb.