ArticleBMC pregnancy and childbirth2010
Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China.
Article in BMC pregnancy and childbirth, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Classifying caesarean section to understand rising rates among Palestinian refugees: results from 290,047 electronic medical records across five settings.BMC pregnancy and childbirth · 2022Pooled it
- Intrathecal morphine versus transversus abdominis plane block for caesarean delivery: a systematic review and meta-analysis.BMC anesthesiology · 2021Pooled it
- Sexual dysfunction and mode of delivery in Chinese primiparous women: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2017Pooled it
- Prevalence of abnormally invasive placenta among deliveries in mainland China: A PRISMA-compliant Systematic Review and Meta-analysis.Medicine · 2017Pooled it
- Oxytocin augmentation of labour in women with epidural analgesia for reducing operative deliveries.The Cochrane database of systematic reviews · 2013Pooled it
- Spinopelvic alignment and pubic symphysis widening are associated with postpartum low back pain: a retrospective case-control study.Frontiers in bioengineering and biotechnology · 2026Article
- Impact of normal vs. caesarean deliveries on child nutritional status and mortality in India: insights from NFHS-5 data.BMC pediatrics · 2024Article
- Socioeconomic inequalities in skilled attendance at birth and caesarean section rates in Myanmar 2015-2016: a cross-sectional study.BMJ open · 2024Article
- Article
- Fentanyl for labour pain management: a scoping review.BMC pregnancy and childbirth · 2022Article
- Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial.Implementation science : IS · 2020Article
- Cesarean sections in a secondary level care hospital of Cameroon: an analysis of their six-year trends and adverse neonatal outcomes.BMC research notes · 2017Article
- Factors influencing attempted and completed suicide in postnatal women: A population-based study in Taiwan.Scientific reports · 2016Article
- Does uterine gauze packing increase the risk of puerperal morbidity in the management of postpartum hemorrhage during caesarean section: a retrospective cohort study.International journal of clinical and experimental medicine · 2015Article
- Combined laparoscopy and hysteroscopy vs. uterine curettage in the uterine artery embolization-based management of cesarean scar pregnancy: a retrospective cohort study.BMC women's health · 2014Article
- Effect of mode of delivery on perceived risks of maternal health outcomes among expectant parents: a cohort study in Beijing, China.BMC pregnancy and childbirth · 2014Article
- Combined laparoscopy and hysteroscopy vs. uterine curettage in the uterine artery embolization-based management of cesarean scar pregnancy: a cohort study.International journal of clinical and experimental medicine · 2014Article
- Cesarean section in the People's Republic of China: current perspectives.International journal of women's health · 2014Review
- Decision-making process for choosing an elective cesarean delivery among primiparas in Taiwan.Maternal and child health journal · 2013Article
- Preference for institutional delivery and caesarean sections in Bangladesh.Journal of health, population, and nutrition · 2013Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery.
methodsAn indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs) in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR) directly. Adjusted RRs were calculated adjusting for propensity score and medical indications.
resultsThe incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4). The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9). The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9) than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications or urinary tract infection.
conclusionsIn nulliparous women who were at low risk, caesarean section was associated with a higher rate of post-partum morbidity. Those requesting the surgical procedure with no conventional medical indication, should be advised of the potential risks.
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