Study Highlights Link Between Maternal Age and Emergency Delivery

A team of researchers from Norway have found that increasing maternal age is linked to the risk of emergency operative delivery.

The study, led by researchers at the Oslo University Hospital, examined the association between maternal age and emergency operative delivery. They focused on a sample of 169,583 low-risk first-time mothers in Norway and found a strong association between increased risk of emergency operative delivery and increased maternal age.

Mike Marsh, BJOG Deputy Editor-in-chief, said, "There is existing evidence of an increase in obstetrical interventions in labour in advanced maternal age, for example induction of labour, use of oxytocin and use of epidural. These interventions may be partly responsible for the increase in emergency operative delivery seen in advanced maternal age. This study is interesting as it focuses on low-risk pregnancies only so it is able to examine the role of other contributing factors in the risk of emergency operative delivery across the maternal age range."

The emergency operative delivery included emergency Casarean section or operative vaginal delivery using forceps or ventouse. The researchers also examined other risk factors for emergency C-sections and operative vaginal delivery. These included: in-labor indications, birth weight of over 4000 g, gestational age of 42 or more weeks, induction of labor and epidural use.

The main clue of emergency operative delivery among women in the cohort was Dystocia and fetal distress. The researchers noticed that women above 40 years of age had 22.4 percent emergency Caesarean section rate and 23.7 percent operative vaginal delivery rate when compared to 6.7 percent and 13 percent respectively in women aged between 20-24 years and 8.4 percent and 16.2 percent in women aged between 25-29 years.

The use of epidural was linked to rise in emergency operative delivery and was greater in older mothers. In those aged between 20-24 years, there was a 5.9 percent difference rate in emergency C-section between women who had epidural and those who did not. The rate increased to 12.9 percent in those who were above 40 years old.

Apart from this - high birth weight, gestational age of 42 weeks or more and induction of labor was linked with higher risk of emergency operative delivery.

Lina Herstad, from the Norwegian Resource Centre for Women's Health and co-author of the study said:

"Our results show that the proportion of operative deliveries increased substantially with maternal age in a low-risk, first time mother cohort. These findings are particularly helpful for both healthcare professionals and women of advanced maternal age in decisions regarding the optimal mode of delivery."

The study was documented in An International Journal of Obstetrics & Gynecology.