The Rate of Cesarean Section Stratified by Maternal Age, Parity and Previous History of Cesarean Section [13Q

Abstract

INTRODUCTION: The purpose of this study is to characterize the rate of cesarean sections (CS) in women < 35 years old against women of advanced maternal age (AMA) >35 years old. This data was further stratified by parity and history of cesarean section. METHODS: This is a retrospective cohort study of 9,676,773 non-anomalous, singleton deliveries 2012-2014 in the United States. In women with and without GDM, we conducted a chi-squared analysis of women < 35 years old and women of AMA and further stratified by parity and history of a CS. RESULTS: Significantly more CS performed on women with GDM than those without GDM in women < 35 years old and of AMA. In women < 35 years old, those with GDM were significantly more likely to have CS than those without GDM (37.0% vs. 26.2%, p < 0.001). Stratifying for nulliparous women < 35 years old with GDM, women were more likely to have CS than those without GDM (36.8% vs. 25.0%, p < 0.001), as well as multiparous women without a history of a CS, and women with a history of CS. Women of AMA with GDM were significantly more likely to have a CS than those without GDM (44.8% vs. 36.8%, p < 0.001). CONCLUSION: GDM is associated with increased risk of cesarean section in women who are < 35 years old and women of AMA. This is also shown when considering parity and cesarean section history. Further research is needed to determine etiology of these differences when considering maternal age, diabetes status and parity.