ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Risk of severe maternal morbidity associated with cesarean delivery and the role of maternal age: a population-based propensity score analysis.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- The Prevalence and Risk Factors for Severe Maternal Morbidities: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Impact of first-trimester preeclampsia screening on perinatal and maternal morbidity: the RANSPRE open multicenter randomized trial.BMC pregnancy and childbirth · 2026Trial
- Maternal complications within six weeks after primary caesarean section in Ghana: a prospective cohort study.BMC pregnancy and childbirth · 2026Article
- Racial and Ethnic Differences in Labor Duration and Cesarean Indications Among Low-Risk Nulliparous Term Singleton Vertex Births: A Retrospective Analysis.Journal of clinical medicine · 2026Article
- Transvaginal hemiperitoneal cervical cerclage for cervical insufficiency: A single-center retrospective study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- The psychological impact of childbirth: Unscheduled cesarean delivery associates with increased risk for acute stress response.Pregnancy (Hoboken, N.J.) · 2026Article
- The association of NICU capacity strain with neonatal mortality and morbidity.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Exploring the risk factors for relaparotomy following cesarean delivery.Archives of gynecology and obstetrics · 2025Article
- Caesarean section for stillborn babies, Benin, Malawi, Uganda and United Republic of Tanzania.Bulletin of the World Health Organization · 2025Article
- Reaching caesarean section rates below 15%: experience of a French tertiary maternity using the Robson classification system.Reproductive health · 2025Observational
- Article
- Cesarean Delivery Outcomes for Patients with Coronavirus Disease-2019 in the USA.Journal of racial and ethnic health disparities · 2025Article
- Role of Emotional Support and Socio-Cultural Atmosphere on the Experience Caesaran Patients: A Systematic Review.Iranian journal of public health · 2024Review
- Maternal pulmonary hypertension and cardiopulmonary outcomes during delivery hospitalization in the United States: A nationwide study from 2016-2020.Pregnancy hypertension · 2024Article
- The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Risk of short-term cardiovascular disease in relation to the mode of delivery in singleton pregnancies: a retrospective cohort study.EClinicalMedicine · 2024Article
- How Much is too Much? High Utilization of Prenatal Care and Its Impact on Primary Cesarean Birth Among Women in the United States.Maternal and child health journal · 2024Article
- Risk factors for relaparotomy after a cesarean delivery: a case-control study.BMC pregnancy and childbirth · 2024Article
- Observational
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundShort-term maternal complications of cesarean delivery remain uncertain because of confounding by indication. Our objective was to assess whether cesarean delivery is associated with severe acute intra- or postpartum maternal morbidity compared with vaginal delivery, overall and according to the timing of the cesarean.
methodsWe performed a case-control analysis using data from EPIMOMS, a prospective population-based study of deliveries at 22 gestation weeks or later from 6 regions of France in 2012-2013. Cases of intra- or postpartum severe acute maternal morbidity that were not a result of a condition present before delivery were compared with controls randomly selected in a 1/50 ratio. Associations between delivery modes and severe acute maternal morbidity were estimated in a propensity score-matched sample.
resultsAmong 182 300 deliveries, we identified 1444 cases and 3464 controls. The proportion of cesarean delivery was significantly higher among cases than controls (36.0% v. 18.2%). In the propensity score-matched analysis, cesarean deliveries were significantly associated with a higher risk of severe acute maternal morbidity (adjusted odds ratio [OR] 1.8, 95% confidence interval [CI] 1.5-2.2). This association increased with maternal age and was particularly marked for women aged 35 years or older (adjusted OR 2.9, 95% CI 1.9-4.4). This increased risk was significant for cesarean deliveries during labour in women of all age groups and for those before labour only in women aged 35 years or older (adjusted OR 5.1, 95% CI 2.3-11.0).
interpretationCesarean delivery is associated with a higher risk of severe acute maternal morbidity than vaginal delivery, particularly in women aged 35 years and older. Clinical decisions regarding delivery mode should account for this excess risk accordingly.
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