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

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.

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).

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.

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.