Complications of cesarean deliveries: rates and risk factors

Am J Obstet Gynecol. 2004 Feb;190(2):428-34. doi: 10.1016/j.ajog.2003.08.037.


Objective: The purpose of this study was to determine complication rates after cesarean delivery and to identify independent risk factors for complications.

Study design: In a prospective population-based cohort study in Norway, rates of predefined types of complications from 2751 cesarean deliveries were determined. The complications that were studied were intraoperative complications, blood loss, wound infection, cystitis, endometritis, hematoma, and reoperation. Independent risk factors were identified by stratification and multiple logistic regression analysis.

Results: Altogether, 21.4% of the women had > or =1 complications. The degree of cervical dilation, general anesthesia, low gestational age, and fetal macrosomia were independent risk factors. For operations that were performed at 9 to 10 cm cervical dilation, the complication rate was 32.6% versus 16.8% at 0 cm (odds ratio, 2.39; 95% CI, 1.77-3.22; P<.001).

Conclusion: Cesarean delivery was associated with a high complication rate. Increasing cervical dilation and, in particular, cervical dilation of 9 or 10 cm at the time of operation, general anesthesia, low gestational age, and fetal macrosomia were identified as independent risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Conduction
  • Anesthesia, General
  • Anesthesia, Obstetrical
  • Blood Loss, Surgical
  • Cesarean Section / adverse effects*
  • Cesarean Section / statistics & numerical data
  • Female
  • Fetal Weight
  • Humans
  • Labor Stage, First
  • Logistic Models
  • Middle Aged
  • Norway / epidemiology
  • Pregnancy
  • Prospective Studies
  • Risk Factors