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BJOG. 2013 Mar;120(4):479-86; discussion 486. doi: 10.1111/1471-0528.12129. Epub 2013 Jan 15.

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

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1
Department of Health Science, Mid Sweden University, Holmgatan 10, Sundsvall, Sweden. annika.karlstrom@miun.se

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.

Comment in

PMID:
23316937
DOI:
10.1111/1471-0528.12129
[Indexed for MEDLINE]
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