Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study

Abstract

Objective: To investigate the association between a mother’s age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics. Methods: Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children). Results: An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54–1.71) to 1.84 (95% CI 1.70–1.99) for age group 35–39 and OR: 2.83 (95% CI 2.60–3.08) to 3.71 (95% CI 3.23–4.27) for age group 40+ compared to age group 25–29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35–39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80–0.91) to 0.87 (95% CI 0.83–0.91) for tertiary-educated compared to secondary-educated women. Conclusions: The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.