Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study

Abstract

Objective To compare maternal complications and infant outcomes for women undergoing elective caesarean sections based on a maternal request and without recorded medical indication with those of women who underwent spontaneous onset of labour with the intention to have a vaginal birth.Design Retrospective register study.Setting Sweden; Medical Birth Register used for data collection.Methods A case-control study of 5877 birth records of women undergoing caesarean sections without medical indication and a control group of 13 774 women undergoing births through spontaneous onset of labour. The control group was further divided into women who actually had a vaginal birth and women who ended up with an emergency caesarean section.Results Maternal complications occurred more frequently among women undergoing caesarean section with odds ratios (OR) for bleeding complications of 2.5 (95% CI 2.1-3.0) in the elective caesarean group and 2.0 (95% CI 1.5-2.6) in the emergency caesarean group. The OR for infections was 2.6 in both groups. Breastfeeding complications were most common in women having an elective caesarean section: 6.8 (95% CI 3.2-14.5). Infant outcomes showed a higher incidence of respiratory distress with an OR of 2.7 (95% CI 1.8-3.9) in the elective caesarean section group compared with infants born by emergency caesarean section. The risk of hypoglycaemia was at least twice as high for infants in the caesarean group.Conclusions Caesarean sections without medical indication as well as emergency caesarean sections were associated with higher risks for maternal and infant morbidity.

The gut microbiota and inflammatory noncommunicable diseases: Associations and potentials for gut microbiota therapies

“…Infants born by CS have a higher incidence of respiratory distress 38 and appear to be at higher risk for developing asthma and atopy 39 , obesity 40 and type 1 diabetes 41 . It has been hypothesized that delayed and aberrant intestinal colonization might contribute to this risk conferred by CS.…”

Factors associated with fear of childbirth: It’s effect on women’s preference for elective cesarean section

“…Cesarean section has been associated with raised women mortality and unhealthy neonatal outcomes, amplified physical and emotional women morbidity and higher costs to health care systems. [15] In Egypt, social norms are passed-on from one generation to another, therefore such norms are important factors on the preferences of delivery by women. Expectant mothers acquire information related to delivery, especially from family members, friends, the environment in which they live, and the process may be impacted by their experiences, recommendations and social authorization.…”

Can the Rate of C-sections Performed in a Level I Perinatal Center Be Reduced? – An Analysis of the University Gynecology Clinic Rostock, 2008 – 2014

“…Arikan et al found no difference in Apgar scores at 5 minutes between vaginal delivery and delivery by C-section [40]. However Karlström et al reported a lower percentage of depressed newborns after planned C-sections compared to vaginal deliveries and subsequent emergency C-sections [13].…”

“…Primary maternal risks include the anesthetic risk, blood loss, infection, thromboembolism, and injuries to internal organs [12][13][14]. The risk of placentation disorders in any subsequent pregnancy is also increased [15,16].…”