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Caesarean section among relatives.

Mette C Tollånes1, Svein Rasmussen, Lorentz M Irgens

  • 1Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. mette.tollanes@isf.uib.no

International Journal of Epidemiology
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A familial predisposition to caesarean section exists, particularly between mothers and daughters, and sisters. This suggests both genetic and environmental factors may influence caesarean birth risk.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Medical Genetics

Background:

  • Rising rates of caesarean section globally necessitate understanding contributing factors.
  • The existence of a familial predisposition to caesarean section remains unclear.

Purpose of the Study:

  • To investigate whether a familial link influences the likelihood of undergoing a caesarean section.
  • To explore potential female-to-female transmission patterns in caesarean birth risk.

Main Methods:

  • Utilized data from the Medical Birth Registry of Norway (1967-2005).
  • Constructed 440,236 grandmother-parent and 275,001 same-sex full sibling units for analysis.
  • Employed log-binomial regression models to assess familial associations.

Main Results:

  • Mothers with a history of caesarean section had a 55% increased risk for their first child (aRR 1.55).
  • Sisters showed a familial predisposition: younger sisters had a 45% increased risk if their older sister had a caesarean section (aRR 1.45).
  • No significant familial risk was observed for fathers or brothers regarding their partners' or siblings' caesarean births.

Conclusions:

  • A clear female-to-female familial predisposition to caesarean section was identified.
  • This predisposition may stem from a combination of biological inheritance (maternal alleles) and shared environmental factors.
  • Both genetic and environmental influences likely play a role in caesarean section occurrence.