ArticleBMC pregnancy and childbirth2021
Maternal age at first cesarean delivery related to adverse pregnancy outcomes in a second cesarean delivery: a multicenter, historical, cross-sectional cohort study.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Maternal age 30-34 years and adverse perinatal outcomes: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Global and regional incidence of intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis.BMC medicine · 2025Pooled it
- Risk factors associated with maternal complications of caesarean delivery in Rwanda: a retrospective cross-sectional study.BMC pregnancy and childbirth · 2026Article
- [Association Study of Parity With Adverse Pregnancy Outcomes].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2026Article
- The influence of advanced maternal age on the success rate, delivery mode and maternal and fetal outcomes of pregnant women undergoing external cephalic version: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Association between parity and adverse maternal and neonatal outcomes: a population-based cross-sectional study.Frontiers in medicine · 2025Article
- Is There an Age Limit for a Trial of Vaginal Delivery in Nulliparous Women?Journal of clinical medicine · 2023Article
- Maternal complications and associated factors among mothers who underwent a cesarean section at Gebretsadik Shewa general hospital: an institution based cross-sectional study.Frontiers in global women's health · 2023Article
- Risk Factors and Pregnancy Outcome in Women with a History of Cesarean Section Complicated by Placenta Accreta.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2022Article
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Authors and funding
23 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundTo determine the effects of maternal age at first cesarean on maternal complications and adverse outcomes of pregnancy with the second cesarean.
methodsThis was a multicenter, historical, cross-sectional cohort study involving singleton pregnancies ≥28 gestational weeks, with a history of 1 cesarean delivery, and who underwent a second cesarean between January and December 2017 at 11 public tertiary hospitals in 7 provinces of China. We analyzed the effects of maternal age at first cesarean on adverse outcomes of pregnancy in the second cesarean using multivariate logistic regression analysis.
resultsThe study consisted of 10,206 singleton pregnancies. Women were at first cesarean between 18 and 24, 25-29, 30-34, and ≥ 35 years of age; and numbered 2711, 5524, 1751, and 220 cases, respectively. Maternal age between 18 and 24 years at first cesarean increased the risk of placenta accreta spectrum (aOR, 1.499; 95% CI, 1.12-2.01), placenta previa (aOR, 1.349; 95% CI, 1.07-1.70), intrahepatic cholestasis of pregnancy (aOR, 1.947; 95% CI, 1.24-3.07), postpartum hemorrhage (aOR, 1.505; 95% CI, 1.05-2.16), and blood transfusion (aOR, 1.517; 95% CI, 1.21-1.91) in the second cesarean compared with the reference group (aged 25-29 years). In addition, maternal age ≥ 35 years at first cesarean was a risk factor for premature rupture of membranes (aOR, 1.556; 95% CI, 1.08-2.24), placental abruption (aOR, 6.464, 95% CI, 1.33-31.51), uterine rupture (aOR, 7.952; 95% CI, 1.43-44.10), puerperal infection (aOR, 6.864; 95% CI, 1.95-24.22), neonatal mild asphyxia (aOR, 4.339; 95% CI, 1.53-12.32), severe asphyxia (aOR, 18.439; 95% CI, 1.54-220.95), and admission to a neonatal intensive care unit (aOR, 2.825; 95% CI, 1.54-5.17) compared with the reference group (aged 25-29 years).
conclusionsMaternal age between 18 and 24 years or advanced maternal age at first cesarean was an independent risk factor for adverse maternal outcomes with the second cesarean. Advanced maternal age at the first cesarean specifically increased adverse neonatal outcomes with the second. Therefore, decisions as to whether to perform a first cesarean at a young or advanced maternal age must be critically evaluated.
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