Cesarean delivery in Finland: maternal complications and obstetric risk factors

Acta Obstet Gynecol Scand. 2010 Jul;89(7):896-902. doi: 10.3109/00016349.2010.487893.


Objective: To assess the rate of maternal complications related to cesarean section (CS) and to compare morbidity between elective, emergency and crash-emergency CS. To establish risk factors associated with maternal CS morbidity.

Design: A prospective multicenter cohort study.

Setting: Twelve delivery units in Finland.

Population: Women delivering by CS (n = 2,496) during a 6 months period in the study hospitals.

Methods: Data on pregnant women, CS, and maternal recovery during the hospital stay was collected prospectively on report forms. The complication rates by different CSs were calculated, and factors associated with morbidity were analyzed by odds ratios (OR).

Main outcome measures: Maternal complication rates in different types of CS. The association of risk factors with morbidity.

Results: About 27% of women delivering by CS had complications; 10% had severe complications. The complication rate was higher in emergency CS than in elective CS, and highest in crash-emergency CS. Significant independent risk factors for maternal morbidity were emergency CS and crash-emergency CS compared to elective CS (OR 1.8; 95% confidence interval (CI) 1.5-2.2), pre-eclampsia (OR 1.5; CI 1.1-2.0), maternal obesity (OR 1.4; CI 1.1-1.8) and maternal increasing age (OR 1.1; CI 1.03-1.2 per each 5 years).

Conclusions: Maternal complications are frequent in CS, and although performing CS electively reduces the occurrence of complications, the frequency is still high. The complication rate depends on the degree of emergency, and increases with maternal obesity, older age and pre-eclampsia.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Analysis of Variance
  • Anesthesia, Obstetrical / adverse effects
  • Anesthesia, Obstetrical / methods
  • Cesarean Section / adverse effects
  • Cesarean Section / methods
  • Cesarean Section / mortality
  • Cesarean Section / statistics & numerical data*
  • Cohort Studies
  • Confidence Intervals
  • Elective Surgical Procedures / adverse effects
  • Elective Surgical Procedures / methods
  • Elective Surgical Procedures / statistics & numerical data*
  • Emergency Treatment / adverse effects
  • Emergency Treatment / methods
  • Emergency Treatment / statistics & numerical data*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant Mortality / trends
  • Infant, Newborn
  • Logistic Models
  • Maternal Age
  • Maternal Mortality / trends
  • Multivariate Analysis
  • Obesity / epidemiology
  • Obstetric Labor Complications / diagnosis
  • Obstetric Labor Complications / epidemiology*
  • Odds Ratio
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Postpartum Hemorrhage / diagnosis
  • Postpartum Hemorrhage / epidemiology
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / surgery
  • Pregnancy Outcome
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome