Table 2.
Prevalence and Relative Risk of Potential Clinical Indications for Elective Primary Cesarean Delivery
| Risk Factor | N (% of Women with Risk Factor) All Patients (463,196) | N (% of Women with Risk Factor and EPC=Yes)* (19,664) | EPC* Rate for Women with Risk Factor | Crude Relative Risk for EPC* among Women with Risk Factor (95% CI) | P Value |
|---|---|---|---|---|---|
| Cerebral hemorrhage | 0.00 (0.00%) | 0.00 (0.00%) | — | 1.00 | <0.001 |
| Asthma | 3,076 (0.66%) | 205 (1.04%) | 6.66% | 1.58 (1.38–1.80) | <0.001 |
| Antepartum bleed | 7,495 (1.62%) | 2,468 (12.55%) | 32.93% | 8.73 (8.42–9.04) | <0.001 |
| Other hypertension | 19,992 (4.32%) | 1,663 (8.46%) | 8.32% | 2.05 (1.95–2.15) | <0.001 |
| Severe hypertension | 3,523 (0.76%) | 1,095 (5.57%) | 31.08% | 7.69 (7.31–8.10) | <0.001 |
| Preterm | 25,919 (5.60%) | 4,043 (20.56%) | 15.60% | 4.37 (4.23–4.51) | <0.001 |
| Renal condition | 495 (0.11%) | 51 (0.26%) | 10.30% | 2.43 (1.87–3.15) | <0.001 |
| Herpes (all) | 4,087 (0.87%) | 1,204 (6.12%) | 29.46% | 7.40 (7.04–7.77) | <0.001 |
| Liver condition | 419 (0.09%) | 31 (0.16%) | 7.40% | 1.74 (1.24–2.45) | 0.002 |
| Abnormal blood sugar | 14,254 (3.08%) | 1,229 (6.25%) | 8.62% | 2.10 (1.99–2.22) | |
| Thyroid condition | 2,069 (0.45%) | 164 (0.83%) | 7.93% | 1.87 (1.62–2.17) | <0.001 |
| Substance use | 2,690 (0.58%) | 165 (0.84%) | 6.13% | 1.45 (1.25–1.68) | <0.001 |
| Mental disorder | 6,798 (1.47%) | 358 (1.82%) | 5.27% | 1.24 (1.12–1.38) | <0.001 |
| Maternal cardiac condition | 2,207 (0.48%) | 182 (0.93%) | 8.25% | 1.95 (1.70–2.24) | <0.001 |
| Multiple gestation | 4,768 (1.03%) | 1,716 (8.73%) | 36.00% | 9.19 (8.83–9.57) | <0.001 |
| Malpresentation | 23,986 (5.18%) | 11,323 (57.58%) | 47.24% | 24.86 (24.24–25.49) | <0.001 |
| Unengaged fetal head | 2,901 (0.63%) | 396 (2.01%) | 13.65% | 3.26 (2.97–3.58) | <0.001 |
| Maternal soft tissue condition | 5,846 (1.26%) | 1,391 (7.07%) | 23.79% | 5.96 (5.68–6.25) | <0.001 |
| Other uterine scar | 419 (0.09%) | 270 (1.37%) | 64.44% | 15.38 (14.30–16.53) | <0.001 |
| Anomaly or abnormal chromosomes | 466 (0/10%) | 83 (0.42%) | 17.81% | 8.73 (8.42–9.04) | <0.001 |
| Isoimmunization | 9,346 (2.02%) | 455 (2.31%) | 4.87% | 1.15 (1.05–1.26) | 0.003 |
| Intrauterine fetal demise | 2,144 (0.46%) | 91 (0.46%) | 4.24% | 1.00 (0.82–1.22) | 1.00 |
| Intrauterine growth restriction | 5,478 (1.18%) | 756 (3.84%) | 13.80% | 3.34 (3.12–3.57) | <0.001 |
| Macrosomia | 10,432 (2.25%) | 1,213 (6.17%) | 11.63% | 2.85 (2.70–3.01) | <0.001 |
| Oligohydramnios | 9,842 (2.12%) | 969 (4.93%) | 9.85% | 2.39 (2.25–2.54) | <0.001 |
| Polyhydramnios | 1,467 (0.32%) | 217 (1.10%) | 14.79% | 3.51 (3.10–3.97) | <0.001 |
| Ruptured membranes >24 hours | 7,462 (1.61%) | 372 (1.89%) | 4.99% | 1.18 (1.07–1.30) | 0.002 |
| Chorioamnionitis | 9,790 (2.11%) | 630 (3.20%) | 6.44% | 1.53 (1.42–1.66) | <0.001 |
| Maternal infection (other than chorio) | 20,713 (4.47%) | 954 (4.85%) | 4.61% | 1.09 (1.02–1.16) | 0.009 |
| Advanced maternal age (≥35 years) | 57,155 (12.34%) | 3,865 (19.66%) | 6.77% | 1.74 (1.68–1.80) | <0.001 |
| Uterine rupture | 104 (0.02%) | 16 (0.08%) | 15.38% | 3.14 (1.99–4.96) | <0.001 |
| Obstetrical shock | 53 (0.01%) | 14 (0.07%) | 26.42% | 6.23 (3.97–9.76) | <0.001 |
| Pulmonary embolism | 31 (0.01%) | 7 (0.04%) | 22.48% | 5.32 (2.77–10.21) | <0.001 |
*
EPC=elective primary cesarean delivery