Featured Research

from universities, journals, and other organizations

Delaying Childbirth Is Associated With Impaired Contraction Of The Uterus And Rising Rates Of Cesarean Section

Date:
July 1, 2008
Source:
Public Library of Science
Summary:
Impaired contraction of the uterus (womb) may play a part in the association of advancing maternal age with increased cesarean rates. Researchers analyzed a large Scottish data base to characterize the association between maternal age and outcome of labor, specifically looking at what proportion of the increase in primary cesarean rates could be attributed to changes in maternal age distribution.

Impaired contraction of the uterus (womb) may play a part in the association of advancing maternal age with increased cesarean rates according to new research. In a two part study, Professor Gordon Smith and colleagues (Cambridge University, UK) analyzed a large Scottish data base to characterize the association between maternal age and outcome of labor, specifically looking at what proportion of the increase in primary cesarean rates could be attributed to changes in maternal age distribution.

Related Articles


They then went on to study samples of myometrium (muscle from the wall of the uterus) taken during routine cesarean sections to determine whether muscle contractility varied with maternal age.

Cesarean sections are associated with higher mortality and morbidity rates compared with vaginal deliveries. Rates of caesarean section have dramatically increased over the last 20-30 years throughout the developed world. This increase is a concern as it may have implications for the mother, baby, healthcare providers, and policy makers. According to the World Health Organization (WHO), the UK's cesarean rate was 20% in 2004, Canada's was 22.5% in 2001-2002 and the United States' was 30.2% in 2005 -- all above the WHO's proposed acceptable rate of between 10% and 15% for countries in the developed world.

Previous epidemiological studies have reported a trend of increased rates of cesarean sections with maternal age which is consistent in different countries. However, the reason for these increased rates remains unclear. Moreover, it was unclear to what extent, if any, the trend of delaying childbirth had contributed to the increased cesarean rates.

This study was carried out in two parts. First, the researchers analyzed data collected by the Scottish Morbidity Record (SMR2) from 1980 to 2005 -- over 0.5m available records. A linear association between the risk of having a cesarean section and advancing maternal age in first pregnancies was found. They observed striking changes over the period of study.

The proportion of women aged 30-34 increased three fold, the proportion aged 35-39 increased seven-fold and the proportion aged 40 or older increased 10-fold. Over the same period, the cesarean rate more than doubled. The researchers estimated that around 38% of the additional procedures would have been avoided if maternal age distribution had remained the same as in 1980. They therefore concluded that a substantial proportion of the increase in cesarean section rates may be due to the trend of delaying first childbirth.

Second, they hypothesized that the increased risk of caesarean section among older women is a result of a biological effect of aging on the ability of the muscle of the uterus to contract. They evaluated this hypothesis by examining biopsies from the uteruses of a separate group of 62 women (of mixed parity) undergoing routine elective cesarean delivery in Cambridge. They found that advancing age was associated with impaired uterine function as evidenced by a reduced degree of spontaneous contraction and the type of spontaneous contraction.

The analysis of Scottish data adds to the evidence that advancing maternal age is associated with higher rates of cesarean sections. Moreover, it indicates that the trend of delaying childbirth has substantially contributed to recent increases in cesarean rates. The researchers' further work at the NIHR Cambridge Biomedical Research Centre at the Rosie Hospital in Cambridge, UK suggests a possible mechanism for this association, i.e., impaired contraction of the uterus. Although further work will be needed in other populations, as the authors comment, "understanding the determinants and management of dysfunctional labor in older women is central to designing strategies for reducing population cesarean delivery rates without adversely affecting maternal and infant outcomes."


Story Source:

The above story is based on materials provided by Public Library of Science. Note: Materials may be edited for content and length.


Journal Reference:

  1. Smith et al. The Effect of Delaying Childbirth on Primary Cesarean Section Rates. PLoS Medicine, 2008; 5 (7): e144 DOI: 10.1371/journal.pmed.0050144

Cite This Page:

Public Library of Science. "Delaying Childbirth Is Associated With Impaired Contraction Of The Uterus And Rising Rates Of Cesarean Section." ScienceDaily. ScienceDaily, 1 July 2008. <www.sciencedaily.com/releases/2008/06/080630201614.htm>.
Public Library of Science. (2008, July 1). Delaying Childbirth Is Associated With Impaired Contraction Of The Uterus And Rising Rates Of Cesarean Section. ScienceDaily. Retrieved November 28, 2014 from www.sciencedaily.com/releases/2008/06/080630201614.htm
Public Library of Science. "Delaying Childbirth Is Associated With Impaired Contraction Of The Uterus And Rising Rates Of Cesarean Section." ScienceDaily. www.sciencedaily.com/releases/2008/06/080630201614.htm (accessed November 28, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, November 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Leaves Orphans Alone in Sierra Leone

Ebola Leaves Orphans Alone in Sierra Leone

AFP (Nov. 27, 2014) — The Ebola epidemic sweeping Sierra Leone is having a profound effect on the country's children, many of whom have been left without any family members to support them. Duration: 01:02 Video provided by AFP
Powered by NewsLook.com
Experimental Ebola Vaccine Shows Promise In Human Trial

Experimental Ebola Vaccine Shows Promise In Human Trial

Newsy (Nov. 27, 2014) — A recent test of a prototype Ebola vaccine generated an immune response to the disease in subjects. Video provided by Newsy
Powered by NewsLook.com
Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) — Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) — Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins