Table 3.
Risk factors for cesarean delivery among nulliparous women with singleton, cephalic, term pregnanciesa
| Women with cesarean delivery (%) | Bivariate analysis | Multivariable analysis | |||
|---|---|---|---|---|---|
| Odds ratio (95% confidence interval) | p-value | Adjusted odds ratio (95% confidence interval) | p-value | ||
| Age at delivery (year) | |||||
| < 25 | 80 (27) | Reference | Reference | ||
| 25–29 | 107 (46) | 2.3 (1.6–3.4) | < 0.01 | 2.3 (1.5–3.4) | < 0.01 |
| 30–34 | 91 (56) | 3.5 (2.3–5.2) | < 0.01 | 3.3 (2.1–5.1) | < 0.01 |
| ≥ 35 | 87 (69) | 6.2 (3.9–9.8) | < 0.01 | 5.6 (3.4–9.2) | < 0.01 |
| Pre-pregnancy body mass indexb | |||||
| Underweight | 46 (31) | 0.6 (0.4–0.9) | < 0.01 | 0.7 (0.5–1.1) | 0.14 |
| Normal | 221 (44) | Reference | Reference | ||
| Overweight | 52 (53) | 1.5 (0.9–2.2) | 0.09 | 1.2 (0.7–2.0) | 0.42 |
| Obese | 38 (73) | 3.5 (1.9–6.6) | < 0.01 | 2.5 (1.2–5.1) | 0.01 |
| Unknown | 8 (73) | 3.4 (0.9–13.1) | 0.07 | 2.7 (0.6–12.1) | 0.20 |
| Existing blood conditionc | |||||
| No | 363 (46) | Reference | Reference | ||
| Yes | 2 (8) | 0.1 (0.02–0.5) | < 0.01 | 0.08 (0.01–0.5) | 0.01 |
| New medical condition during the current pregnancyb, d | |||||
| No | 354 (44) | Reference | Reference | ||
| Yes | 11 (92) | 14.0 (1.8–108.6) | 0.01 | 35.1 (2.3–527.0) | 0.01 |
| Fetal distress during current deliveryb | |||||
| No | 331 (43) | Reference | Reference | ||
| Yes | 34 (89) | 11.5 (4.0–32.6) | < 0.01 | 16.1 (5.4–47.6) | < 0.01 |
| Dysfunctional labor/failure to progress during current deliveryb | |||||
| No | 349 (44) | Reference | Reference | ||
| Yes | 16 (84) | 6.8 (2.0–23.6) | < 0.01 | 6.3 (1.7–24.2) | < 0.01 |
| Baby size for gestational age percentile based on INTERGROWTH-21st standardb | |||||
| < 10th | 28 (29) | Reference | Reference | ||
| 10-19th | 35 (31) | 1.1 (0.6–2.0) | 0.74 | 1.2 (0.6–2.3) | 0.65 |
| 20-29th | 32 (36) | 1.4 (0.7–2.6) | 0.31 | 1.2 (0.6–2.5) | 0.55 |
| 30-39th | 35 (41) | 1.7 (0.9–3.2) | 0.09 | 1.5 (0.8–3.0) | 0.24 |
| 40-49th | 32 (39) | 1.6 (0.9–3.0) | 0.14 | 1.6 (0.8–3.2) | 0.18 |
| 50-59th | 40 (51) | 2.6 (1.4–4.3) | < 0.01 | 2.3 (1.1–4.5) | 0.02 |
| 60-69th | 41 (48) | 2.3 (1.3–4.3) | 0.01 | 2.1 (1.1–4.1) | 0.03 |
| 70-79th | 41 (59) | 3.7 (1.9–7.0) | < 0.01 | 2.8 (1.3–5.7) | < 0.01 |
| 80-89th | 43 (69) | 5.7 (2.8–11.3) | < 0.01 | 5.5 (2.6–11.8) | < 0.01 |
| ≥ 90th | 37 (79) | 9.2 (4.0–21.1) | < 0.01 | 6.9 (2.3–16.8) | < 0.01 |
| Unknown | 1 (25) | 0.8 (0.1–8.6) | 0.88 | 0.8 (0.1–8.2) | 0.84 |
| Self-pay for delivery fees | |||||
| Yes | 65 (54) | 1.5 (1.0–2.3) | 0.03 | 1.7 (1.1–2.8) | 0.02 |
| No | 300 (43) | Reference | Reference | ||
aOnly women with gestational weeks at delivery and mode of delivery information were included; analyses taken into account the following items: characteristics of participants (age, nationality, marital status, employment, education, pre-pregnancy body mass index, insurance type, monthly household income, possession of household items, location of residence, use of cigarette and alcohol, and psychological stressor); delivery facility; year; prenatal care history (number of visits, trimester at first visit); illness history (type and number of existing chronic condition, type of new or worsen condition, hospitalization history); complication during current pregnancy (type and number of complication, trimester at diagnosis); and baby weight at delivery
bInformation abstracted from medical records
cBlood problem such as sickle cell disease, thalassemia, hemoglobinopathy
dQuestions asking about the following conditions: respiratory/lung problem; heart disease or heart condition; endocrine disorder such as thyroid problem or diabetes; blood problem such as sickle cell disease, or thalassemia; kidney or bladder disease; hepatitis, jaundice or liver disease, excluding hepatitis A and E; problem with the immune system, excluding HIV; cancer; neurologic or neuromuscular disorder; HIV infection; mental health condition such as anxiety or depression; and others