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Recent Lifestyle Parameters Are Associated with Increasing Caesarean Section Rates among Singleton Term Births in Austria

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  • Sylvia Kirchengast

    (Department of Anthropology, University of Vienna, A-1090 Vienna, Austria)

  • Beda Hartmann

    (Clinic for Gynaecology and Obstetrics, Danube Hospital, A-1220 Vienna, Austria)

Abstract

Caesarean section (CS) rates are increasing in many parts of the world, recently reaching about 20% worldwide. The postmodern lifestyle characteristics, obesity and delayed childbirth, have been put forward as the main reasons for high CS rates. The present study tests the association patterns between lifestyle parameters and delivery mode on a data set of 3786 births in Vienna between 2005 and 2013. The focus is exclusively on singleton term births. As well as maternal age, prepregnancy weight status, maternal body height and gestational weight gain, newborn size (birth weight, birth length, and head circumference), Apgar scores and child presentation were recorded. Planned as well as emergency CS rates increased significantly ( p < 0.0001) with increasing maternal age and decreasing maternal body height. Emergency CS rates, however, increased significantly with increasing maternal prepregnancy weight status and gestational weight gain. An especially high risk of emergency CS occurred among four groups of mothers: those older than 40 years (OR = 2.68; 95% CI 1.87–3.86), those who were obese (OR = 1.44; 95% 1.15–1.81), those experiencing a gestational weight gain above 15 kg (OR = 1.32; 95% CI 1.13–1.54), and those shorter than 160 cm (OR = 1.216; 95% CI 1.02–1.45). Emergency CS rates were significantly higher among low-weight newborns (<2500 g) and macrosome newborns (>4000 g) than among normal-weight newborns. Furthermore, breech presentation was associated with an increased risk of caesarean delivery (OR 6.97; 95% CI 6.09–7.96). Logistic regression analyses reveal that maternal age, maternal body height, prepregnancy weight status, gestational weight gain, birth weight, newborn head circumference and child presentation show an independent, highly significant association with caesarean delivery. We conclude that maternal and newborn characteristics typical of recent lifestyle patterns, such as advanced maternal age, obesity, increased gestational weight gain and increased newborn size, are highly significantly associated with increased emergency CS rates. Moreover, maternal shortness and breech presentation are risk factors for emergency CS.

Suggested Citation

  • Sylvia Kirchengast & Beda Hartmann, 2018. "Recent Lifestyle Parameters Are Associated with Increasing Caesarean Section Rates among Singleton Term Births in Austria," IJERPH, MDPI, vol. 16(1), pages 1-13, December.
    • Handle: RePEc:gam:jijerp:v:16:y:2018:i:1:p:14-:d:192269
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    References listed on IDEAS

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    1. Lovney Kanguru & Affette McCaw-Binns & Jacqueline Bell & Novie Yonger-Coleman & Rainford Wilks & Julia Hussein, 2017. "The burden of obesity in women of reproductive age and in pregnancy in a middle-income setting: A population based study from Jamaica," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-14, December.
    2. Sunita Panda & Cecily Begley & Deirdre Daly, 2018. "Clinicians’ views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-27, July.
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    Cited by:

    1. Sylvia Kirchengast & Josef Fellner & Julia Haury & Magdalena Kraus & Antonia Stadler & Teresa Schöllauf & Beda Hartmann, 2024. "The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors—The IOM Criteria Reconsidered," IJERPH, MDPI, vol. 21(2), pages 1-14, January.
    2. Sylvia Kirchengast & Beda Hartmann, 2021. "Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria," IJERPH, MDPI, vol. 18(7), pages 1-14, April.

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