Maternal and neonatal outcomes following cesarean delivery on maternal request at different parities in China: A...

Cesarean delivery on maternal request (CDMR) has been associated with an elevated a higher incidence of postpartum maternal and neonatal complications when compared to vaginal delivery. However, there is a notable lack of research investigating the influence of parity on the maternal and neonatal complications linked to CDMR, particularly within the Chinese population. This prospective cohort study, conducted in China, aims to investigate the short-term maternal and neonatal complications associated with CDMR among low-risk nulliparous and parous populations. Methods The study cohort consisted of 336 women, including both nulliparous and parous (second birth and first cesarean delivery) who elected for CDMR. Comprehensive data regarding maternal and neonatal complications were collected during the perioperative period and throughout the first year postpartum.

After adjusting for age-related factors, our findings reveal that nulliparous experienced a higher incidence of postoperative complications. These complications included delayed initiation of breastfeeding, increased activity-related pain within 48 hours post-surgery, and a greater frequency of Patient-Controlled Epidural Analgesia (PCEA) activations, a higher incidence of pruritus and mastitis, and prolonged postoperative hospital stays (all P < 0.05). Furthermore, the risk of hospitalization due to neonatal jaundice was significantly elevated among the newborns of nulliparous (P < 0.05).

In comparison to parous (second birth and first cesarean delivery), nulliparous who underwent CDMR exhibited a higher incidence of short-term maternal and neonatal complications. It is recommended that the potential maternal and neonatal complications associated with CDMR be carefully evaluated when determining the mode of delivery for nulliparous.