Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study

Int J Environ Res Public Health. 2022 Dec 30;20(1):668. doi: 10.3390/ijerph20010668.

Abstract

Objective: To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics.

Methods: Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children).

Results: An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54-1.71) to 1.84 (95% CI 1.70-1.99) for age group 35-39 and OR: 2.83 (95% CI 2.60-3.08) to 3.71 (95% CI 3.23-4.27) for age group 40+ compared to age group 25-29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35-39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80-0.91) to 0.87 (95% CI 0.83-0.91) for tertiary-educated compared to secondary-educated women.

Conclusions: The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.

Keywords: Czechia; caesarean section (CS); education; fertility postponement; marital status; maternal age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cesarean Section*
  • Child
  • Female
  • Humans
  • Maternal Age
  • Mothers
  • Parturition*
  • Pregnancy
  • Risk Factors

Grants and funding

This research was supported by the Czech Science Foundation: No. 18-08013S—Transition towards the late childbearing pattern: individual prospects versus societal costs. NPO “Systemic Risk Institute”, number LX22NPO5101, funded by the European Union—Next Generation EU (Ministry of Education, Youth and Sports, NPO: EXCELES).