Elective Cesarean Section or Not? Risk of Advance Maternal Age at First Birth

Abstract

. The existing literature suggests that the increase of cesarean section (c-section) is predominantly due to advanced maternal age (AMA), particularly in nulliparous women. We examined the association between AMA and elective c-section in primiparous women with singleton pregnancy. This study used data from the 2017 Indonesia Demographic and Health Survey (IDHS). Multinomial logistic regression was performed to examine the relationship between AMA and elective c-section. The final sample analysis comprises 4,988 observations. This study found that AMA at birth significantly associated with elective c-section among primiparous women with singleton pregnancy (RRR: 7.98; 95% CI 4.85-13.11). The possible explanation of this finding is pre-pregnancy morbidities, abnormal labor, and uterine dysfunction among the AMA group. Despite the comprehensive dataset, the study has limitations. The design does not allow for a causal interpretation of the associations studied. Further research through cohort studies including biological variables and maternal preferences are recommended.