Severe postpartum morbidity and mode of delivery: a retrospective cohort study.
The aim of this population-based study was to estimate the risk of postpartum maternal complications associated with mode of delivery in a population of low-risk pregnancies. Data from 324,883 full-term singleton births between 2001 and 2007 were retrieved from birth and hospital discharge databases of the Lazio Region, Central Italy. Women with breech presentation births and those with chronic/pregnancy-related diseases in the mother/fetus were excluded. The association between mode of delivery and maternal outcome was estimated for women by odds ratios (ORs), adjusted for potential confounders. Of nulliparous women 78.6% intended vaginal delivery, while for multiparous this was 68.6%. Elective cesarean section was associated with a higher risk of hysterectomy, obstetric shock and anesthetic complications compared with women in the intended vaginal delivery group. This suggests there is a need for a program to reduce unnecessary elective cesarean sections.
Public Health Agency, Lazio Region, Rome, Italy. farchi@asplazio.it
Sara
S
Farchi
Arianna
A
Polo
Francesco
F
Franco
Domenico
D
Di Lallo
Gabriella
G
Guasticchi
D000328:Adult; D017677:Age Distribution; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D016001:Confidence Intervals; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000453:epidemiology*; D016017:Odds Ratio; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D047929:Term Birth; D055815:Young Adult