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PREGNANCY & CHILDBIRTH | Increase in C-Section Deliveries Coincides With Increase in Complications During Birth, Study Finds

PREGNANCY & CHILDBIRTH | Increase in C-Section Deliveries Coincides With Increase in Complications During Birth, Study Finds
[Jan. 21, 2009]

An increase in the number of Caesarean sections performed in the U.S. coincides with an increase in severe complications during birth, according to a study scheduled to be published in the February issue of the Journal of Obstetrics and Gynecology, USA Today reports.

For the study, researchers analyzed data from the largest U.S. inpatient database, which sampled hospitals from 37 states in 2005, to examine the rate of severe complications among women who gave birth during two time periods: 1998 to 1999 and 2004 to 2005. The researchers found a 90% increase in blood transfusions; a 50% increase in pulmonary embolisms; and a 20% increase in kidney failure, respiratory disease, shock and the need for a ventilator. The percentage of c-section deliveries with at least one complication increased from 0.64% in 1998 to 1999 to 0.81% in 2004 to 2005.

The researchers found the increased number of c-sections led to an increase in kidney failure, respiratory distress syndrome and ventilation and played a minor role in the increase in cases of shock, pulmonary embolisms and transfusions. The researchers said that although the average age of women giving birth has increased, this did not have a significant effect on the rate of complications.

Susan Meikle, a medical officer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development and co-author of the study, said, "Even though the absolute numbers [of complications] are low, the rates are increasing," adding, "We could do a better job at tracking these complications. There may be short-term trade-offs and long-term trade-offs" for vaginal and c-section deliveries (Rubin, USA Today, 1/21). Meikle added that the study found "an amazing consistency” from vaginal delivery, where complication rates were the lowest, to repeat c-sections, where researchers saw an increase, to primary c-section delivery, where the increases in complications were the highest. "What we were trying to do is make sure that women and families are aware of all the risks so when they make these decisions they are making informed decisions and doctors are able to give them good information," Meikle said (Shelton, Chicago Tribune/Albany Times Union, 1/21).

Michael Kramer, scientific director of the Canadian Institute of Human Development, Child and Youth Health, said it is possible that a complication could trigger the need for a c-section. However, he added that physicians often underestimate the risks of c-sections (USA Today, 1/21).