Table 3.
Rates of indications for cesarean delivery in 1980, 1990, 2000 and 2010 in the United States and relative change in rates in 1990, 2000 and 2010 with reference to the rate in 1980
| Indications for cesarean delivery | 1980 (n=3,712,473) | 1990 (n=3,965,699) | 2000 (n=3,665,629) | 2010 (n=3,866,303) | ||||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| % | RR (95% CI) | % | RR (95% CI) | % | RR (95% CI) | % | RR (95% CI) | |
| Non-reassuring fetal status | 1.7 | 1.00 (Ref) | 8.8 | 5.19 (5.15, 5.23) | 10.3 | 6.07 (6.02, 6.13) | 12.9 | 7.63 (7.57, 7.69) |
| Ischemic placental disease | 4.5 | 1.00 (Ref) | 5.8 | 1.29 (1.28, 1.30) | 8.2 | 1.83 (1.82, 1.84) | 9.7 | 2.15 (2.14, 2.16) |
| Hypertensive disorders1 | 3.6 | 1.00 (Ref) | 4.3 | 1.19 (1.18, 1.20) | 6.2 | 1.73 (1.72, 1.75) | 6.9 | 1.92 (1.91, 1.94) |
| Fetal growth restriction | 0.3 | 1.00 (Ref) | 0.9 | 2.69 (2.64, 2.75) | 1.4 | 4.22 (4.13, 4.30) | 2.3 | 6.70 (6.58, 6.83) |
| Placental abruption | 0.7 | 1.00 (Ref) | 0.9 | 1.24 (1.22, 1.26) | 0.9 | 1.28 (1.26, 1.30) | 1.0 | 1.39 (1.37, 1.41) |
| Malpresentation | 3.3 | 1.00 (Ref) | 4.0 | 1.23 (1.22, 1.24) | 4.7 | 1.42 (1.41, 1.43) | 4.5 | 1.36 (1.35, 1.37) |
| Breech presentation | 3.0 | 1.00 (Ref) | 2.9 | 0.99 (0.98, 0.99) | 2.8 | 0.93 (0.92, 0.94) | 2.8 | 0.94 (0.93, 0.94) |
| Transverse lie | 0.2 | 1.00 (Ref) | 0.5 | 2.01 (1.96, 2.06) | 0.6 | 2.67 (2.60, 2.74) | 0.5 | 2.22 (2.16, 2.27) |
| Other malpresentation | 0.1 | 1.00 (Ref) | 0.7 | 6.41 (6.20, 6.63) | 1.3 | 12.41 (12.02, 12.82) | 1.2 | 11.50 (11.14, 11.88) |
| Labor complications | 6.8 | 1.00 (Ref) | 12.3 | 1.81 (1.80, 1.82) | 13.1 | 1.94 (1.93, 1.95) | 12.4 | 1.84 (1.83, 1.85) |
| Arrest of labor | 6.7 | 1.00 (Ref) | 11.4 | 1.71 (1.70, 1.72) | 11.1 | 1.66 (1.65, 1.67) | 10.5 | 1.57 (1.56, 1.58) |
| Macrosomia | 0.1 | 1.00 (Ref) | 1.0 | 14.77 (14.20, 15.37) | 2.4 | 34.80 (33.46, 36.19) | 2.4 | 34.84 (33.50, 36.23) |
| Prior cesarean | 5.1 | 1.00 (Ref) | 10.6 | 2.08 (2.07, 2.09) | 12.0 | 2.35 (2.34, 2.37) | 15.8 | 3.10 (3.09, 3.12) |
| Low-risk deliveries2 | 81.1 | 1.00 (Ref) | 60.5 | 0.75 (0.74, 0.75) | 53.1 | 0.66 (0.65, 0.66) | 50.7 | 0.63 (0.62, 0.63) |
1
Hypertensive disorders include gestational hypertension, mild and severe preeclampsia, eclampsia or superimposed preeclampsia
2
Low risk deliveries include women without any of the indications for primary cesarean deliveries and women that delivered at term RR, risk ratio; CI confidence interval