ABSTRACT
OBJECTIVE: The current study aimed to evaluate the profile of women who are most likely to undergo caesarean delivery on maternal request (CDMR) and clarify their reasons for this decision. METHODS: For this multicentre case-control study, data were collected from 429 women who underwent CDMR and 429 matched controls who delivered vaginally from June, 2008 through February, 2009. Participants were interviewed by telephone regarding sociodemographic variables, health and lifestyle. RESULTS: CDMR predictors were as follows: increasing age (OR = 1.09/year; 95%CI: 1.05-1.14), family status (unmarried without a steady partner versus married - OR = 3.60; 95%CI: 1.08-11.97), decreasing level of religiosity (secular versus ultra-orthodox - OR = 11.82; 95%CI: 3.75-37.21), and never having engaged, or ceasing sports activity during pregnancy (OR = 1.79; 95%CI: 1.09-2.91 and 2.38; 95%CI: 1.28-4.43, respectively). Above average income reduced the probability of CDMR (OR = 0.56; 95%CI: 0.33-0.94). The most frequent reasons for choosing CDMR were concern for pain (21.9%), concern for their own or baby's health (20.4% and 16.5%, respectively) and emotional aspects (10.0%). CONCLUSIONS: Older, unmarried and/or secular women had increased probability of CDMR. Addressing specific concerns regarding vaginal delivery may provide the basis for a patient-oriented intervention for preventing unnecessary surgery.
Subject(s)
Cesarean Section/psychology , Elective Surgical Procedures/psychology , Adult , Case-Control Studies , Cesarean Section/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Female , Humans , Pregnancy , Young AdultABSTRACT
OBJECTIVE: To determine whether maternal, placental or fetal compartment contributes to the high levels of cord blood adiponectin. STUDY DESIGN: Serum adiponectin levels were compared from 62 newborns and their mothers as well as 32 newborns at delivery and 4 days postpartum. In addition, human placental tissues were tested for the presence of adiponectin mRNA by reverse transcriptase polymerase chain reaction. RESULTS: Cord blood serum adiponectin levels were significantly higher and did not correlate with maternal adiponectin levels (32.5 +/- 7.5 vs. 11.0 +/- 3.6 microg/mL, p < 0.001). Cord blood and day 4 serum adiponectin did not differ significantly (32.6 +/- 7.6 vs. 29.5 +/- 8.4 microg/mL, p < 0.3). In addition, adiponectin mRNA was not expressed in the placenta. CONCLUSION: These findings preclude the possibility of a placental or maternal origin of cord adiponectin. Thus, the high cord adiponectin levels may be attributed to fetal tissues.
