Pregnant women who deliver by c-section are more than three times as likely to die than their peers who deliver vaginally, according to a new report. The heightened mortality risk appears to relate to an increased likelihood of blood clots, infection, or complications from anesthesia, the report suggests.
The rising rates of c-section in many parts of the world prompted Dr. Catherine Deneux-Tharaux, from Maternite Hopital Tenon in Paris, and colleagues to reevaluate the association between c-section and maternal mortality.
Previous studies looking at this topic have yielded conflicting results, the authors point out. Moreover, most of the studies are fairly old and, therefore, do not take into account recent changes in anesthesia and obstetrical care.
The researchers looked at 65 pregnant women who died following delivery between 1996 and 2000 and 10,244 control subjects who delivered uneventfully in 1998.
Women who delivered by c-section were 3.6-times more likely to die than those who delivered vaginally, the authors state. A significantly elevated mortality rise was seen whether the c-section was performed before or during a trial of labor.
As mentioned, c-section was linked to increased risks of death from anesthesia complications, infection, and blood clots, but not from postpartum bleeding.
“Although cesarean delivery is increasingly perceived as a low-risk procedure, the present study suggests that it is still associated with an increased risk of postpartum maternal death as compared with vaginal delivery, even when performed before labor,” the researchers emphasize.
“Knowledge of the specific causes involved in this excess maternal mortality risk should inform preventive strategies at cesarean delivery,” they conclude.
SOURCE: Obstetrics and Gynecology September 2006.