Original ArticlesObstacles to reducing cesarean rates in a low-cesarean setting: the effect of maternal age, height, and weight
Section snippets
Materials and methods
The Swedish Birth Register, maintained by the National Board of Health and Welfare, contains data on more than 99% of births in Sweden. Starting with the first antenatal visit, information is collected prospectively from all hospital births, including information about sociodemographic characteristics, previous reproductive history, pregnancy, and delivery. Such information is forwarded to the Birth Register through copies of standardized individual antenatal, obstetric, and pediatric records,
Results
Among the 92,623 single births were 11,037 cesarean deliveries (11.9%). In the univariate analyses presented in Table 1, maternal age, maternal height, and prepregnancy BMI had the strongest association with the risk of cesarean. Maternal education, mother’s place of birth, and type of hospital also influenced cesarean rates significantly, whereas smoking habits and family situation did not.
Adjusted ORs for the association between cesarean, maternal characteristics, and type of hospital are
Discussion
Maternal age, prepregnancy BMI, and maternal height were the primary influences on the risk for cesarean delivery in this large population-based cohort study. The importance of maternal anthropometric measures is emphasized by the synergistic effects of height and prepregnancy BMI on cesarean rates, which increased by BMI within each height category. Specifically, among tall (at least 175 cm) women, rates of cesarean increased from 5% among lean women to 11% among obese women, whereas the
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