Baghurst Peter, Robson Stephen, Antoniou Georgia, Scheil Wendy, Bryce Robert
School of Reproductive Medicine and Paediatrics, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Aust N Z J Obstet Gynaecol. 2014 Jun;54(3):237-43. doi: 10.1111/ajo.12182. Epub 2014 Feb 8.
Caesarean section rates in Australia rose over the period 1999-2009, as did maternal age at first birth. The contribution of the rise of maternal age to the rise in caesarean sections remains unclear.
To estimate the effect of increasing maternal age on the incidence of emergency caesarean section or instrumental delivery in term singleton first births in South Australia.
We undertook a population-based study of 117 981 term singleton first births, which followed labour during the period 1991-2009, using data from the South Australian Perinatal Statistics Collection. The main outcome measures were deliveries other than spontaneous vaginal births (SVB) (emergency caesarean section or instrumental birth) and emergency caesarean section alone. Logistic regression analysis was performed.
Increasing maternal age at first birth was found to be associated with delivery other than SVB and emergency caesarean section. The adjusted odds of delivery other than SVB increased multiplicatively by approximately 1.49 (95% CI, 1.47-1.51) per five-year rise in maternal age, and the odds of emergency caesarean section increased multiplicatively by approximately 1.39 (95% CI, 1.37-1.42) per five-year rise. Although there are likely to be many reasons for the effect, increases in maternal age at first birth made a contribution in up to 75% of the observed increase in delivery other than SVB from 44.0% to 49.6% over the study period.
Rising maternal age at first birth appeared to contribute to a large proportion of the increase in deliveries other than SVB in South Australia.
1999年至2009年期间，澳大利亚的剖宫产率有所上升，初产时的产妇年龄也有所增加。产妇年龄上升对剖宫产率上升的影响尚不清楚。
评估产妇年龄增加对南澳大利亚足月单胎初产时急诊剖宫产或器械助产分娩发生率的影响。
我们利用南澳大利亚围产期统计数据，对1991年至2009年期间117981例足月单胎初产进行了一项基于人群的研究，跟踪分娩情况。主要结局指标为非自然阴道分娩（SVB）（急诊剖宫产或器械助产）以及单独的急诊剖宫产。进行了逻辑回归分析。
发现初产时产妇年龄增加与非SVB分娩和急诊剖宫产有关。产妇年龄每增加五岁，非SVB分娩的校正比值增加约1.49倍（95%CI，1.47 - 1.51），急诊剖宫产的比值增加约1.39倍（95%CI，1.37 - 1.42）。尽管这种影响可能有多种原因，但在研究期间，初产时产妇年龄增加对非SVB分娩从44.0%增至49.6%的观察到的增加中，贡献高达75%。
初产时产妇年龄上升似乎在很大程度上导致了南澳大利亚非SVB分娩的增加。
