Perinatal and social factors predicting caesarean birth in a 2004 Australian birth cohort

Date

2017

Authors

Robson, Stephen
Vally, Hassan
Mohamed, Abdel-Latif
Yu, Maggie
Westrupp, Elizabeth M

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

Background: The proportion of babies born by caesarean section in Australia has almost doubled over the last 25 years. Factors known to contribute to caesarean such as higher maternal age, mothers being overweight or obese, or having had a previous caesarean do not completely account for the increased rate and it is clear that other influences exist. Aim: To identify previously unsuspected risk factors associated with caesarean using nationally-representative data from the Longitudinal Study of Australian Children. Methods: Data were from the birth cohort, a long-term prospective study of approximately 5000 children that includes richly-detailed data regarding maternal health and exposures during pregnancy. Logistic regression was used to examine the contribution of a wide range of pregnancy, birth and social factors to caesarean. Findings: 28% of 4862 mothers were delivered by caesarean. The final adjusted analyses revealed that use of diabetes medication (OR = 3.1, 95% CI = 1.7–5.5, p < 0.001) and maternal mental health problems during pregnancy (OR = 1.3, CI = 1.1–1.6, p = 0.003) were associated with increased odds of caesarean. Young maternal age (OR = 0.6, CI = 0.5–0.7, p < 0.001), having two or more children (OR = 0.7, CI = 0.6–0.9, p < 0.001), and fathers having an unskilled occupation (OR = 0.7, CI = 0.6–1.0, p = 0.036) were associated with reduced odds of caesarean. Conclusion: Our findings raise the prospect that the effect of additional screening and support for maternal mental health on caesarean rate should be subject of prospective study.

Description

Keywords

Caesarean section, Longitudinal study, Risk factors, Population, Perinatal

Citation

Source

Women and Birth

Type

Journal article

Book Title

Entity type

Access Statement

License Rights

Restricted until

2099-12-31