Maternal complications and cesarean section without indication: systematic review and meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Surgical Outcomes

Background:

• Cesarean sections are increasingly common globally.
• Understanding risks associated with non-medically indicated cesarean births is crucial for maternal safety.

Purpose of the Study:

• To assess severe acute maternal complications linked to cesarean sections performed without a medical indication.
• To provide evidence-based insights into the risks of elective cesarean deliveries.

Main Methods:

• A systematic review and meta-analysis of relevant literature.
• Searched PubMed, Lilacs, and Web of Science databases for studies on cesarean section, natural childbirth, and maternal morbidity/mortality.
• Included eight studies encompassing 1,051,543 individuals.

Main Results:

• Cesarean section was associated with a higher likelihood of maternal death (OR = 3.10) and postpartum infection (OR = 2.83).
• Cesarean section showed a reduced likelihood of postpartum hemorrhage (OR = 0.52).
• No significant association was found between delivery type and the need for blood transfusion.

Conclusions:

• Evidence quality was moderate for maternal death and postpartum infection, and low for hemorrhage and blood transfusion.
• Cesarean sections require careful consideration, particularly when elective, to ensure benefits outweigh surgical risks.
• Emphasizes the need for cautious application of cesarean procedures in clinical practice.