Elective & emergency caesareans associated with higher maternal/infant risk of morbidity.

by faithgibson on April 28, 2013

in Contemporary Childbirth Politics

Thanks to Jen Kamel’s VBACFacts facebook page and an alert reader we now have a link to a study:

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.

Karlström A, Lindgren H, Hildingsson I.

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



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.

Retrospective register study.

Sweden; Medical Birth Register used for data collection.


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.


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: an 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.


Caesarean sections without medical indication as well as emergency caesarean sections were associated with higher risks for maternal and infant morbidity.

© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.
[PubMed – indexed for MEDLINE]

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