Incidence and risks of caesarean section in women aged ≥ 40 years

Abstract

Objective. Evaluating the rates of childbirth in women over 40 years of age in Tuscany (Italy) outlining the indications for caesarean section in this parturient population. Methods. 227,871 women who delivered in Tuscany from 2011 to 2018 using data of Birth Assistance Certificate linked with hospital discharge registry were observed. Caesarean section indications were reported as dismissal diagnoses. Logistic models (adjusted for parity, ART and BMI) were carried out for the maternal age risk factor. Results. The caesarean section rate increases significantly with age. Multivariate analysis confirmed that women over 40 years of age have a higher risk of a caesarean section due to pathologies such as diabetes or eclampsia which are clearly more frequent in these categories of women. Furthermore, the data shows that the caesarean section in some cases was carried out due solely to the age of a primiparous woman. Conclusions. The phenomenon affects health services and social costs and should make us reflect upon the underlying reasons that bring women to delay their reproductive project and where necessary implement appropriate political strategies.