Gynecology and Reproductive Endocrinology

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Special Issue Article - Gynecology and Reproductive Endocrinology (2021) Volume 5, Issue 4

Incidence and risks of caesarean section in women aged â?¥ 40 yrs

Statement of the Problem: Caesarean section is a frequent type of delivery in Italy when complications show up and it’s frequent in women giving birth at higher age. This is not a risk-free procedure, both for the mother and the children, so it’s important to evaluate the incidence of its application. The purpose of this study is to evaluate the rates of childbirth in women over 40 years of age in Tuscany (Italy) outlining the indications for caesarean section in this parturient population. Methodology: 251,407 women who delivered in Tuscany from 2011 to 2019 using data of Birth Assistance Certificate linked with hospital discharge registry were observed. Caesarean section indications were reported as dismissal diagnoses. Logistic models (adjusted for parity, ART and BMI) were carried out for the maternal age risk factor. Findings: In Tuscany, women who deliver at 40 and over increased from 7.4% of pregnant women in 2011 to 9.9% in 2019. Even women aged at least 43 years increased from 1.6% to 2.8%.Caesarean section is performed more frequently in women aged 40 and over: 39.4% at 40-42 years, 58.2% at 43 and more (25.4% in women under 40), both in single and in multiple pregnancies. The caesarean section rate increases significantly with age. Multivariate analysis confirmed that women over 40 years of age have a higher risk of a caesarean section due to pathologies such as diabetes or eclampsia which are clearly more frequent in these categories of women. Furthermore, the data shows that the caesarean section in some cases was carried out due solely to the age of a primiparous woman. Conclusion & Significance: The phenomenon affects health services and social costs and should make us reflect upon the underlying reasons that bring women to delay their reproductive project and where necessary implement appropriate political strategies.

Author(s): Dr Monia Puglia

Abstract Full Text PDF

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