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Updated: May 13, 2025

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Published on: June 6, 2020
Birth by Caesarean section and female offspring's risk of Caesarean section delivery
Stefan Kuhle1, Mary M Brown2, Victoria M Allen3
1Perinatal Epidemiology Research Unit, Depts of Obstetrics & Gynaecology and Pediatrics, Dalhousie University, Halifax, NS, Canada; Institute of Clinical Epidemiology, Public Health, Health Economics, Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.
Background:
The objective of this study was to examine the association of birth by Caesarean section (CS) with female offspring's risk of CS delivery.
Methods:
We used data from the 3G Multigenerational Cohort, which includes women whose births and their own subsequent pregnancies and deliveries were recorded in the population-based Nova Scotia Atlee Perinatal Database. The current analysis was limited to the women's first delivery (n = 23,605). Confounding variables were identified using a directed acyclic graph. The association between birth by CS and later CS delivery was examined with Poisson regression adjusted for confounding variables.
Results:
Seventeen percent of women were born via CS, and 23 % delivered by CS. Compared to women born vaginally, women born by CS had an adjusted relative risk (RR) of 1.36 (95 % confidence interval [CI] 1.30, 1.43) for delivering by CS. Restricting the sample to women born to nulliparous mothers did not change the association (RR 1.35), while restriction to women born out of low-risk pregnancies weakened it slightly (RR 1.25).
Conclusions:
Birth by CS is associated with a 36 % increased risk of women delivering their first child by CS. This increase is likely due to shared medical and socio-cultural factors.
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