558: The association between maternal age and primary cesarean delivery in the U.S. between 1996 and 2004

Poster Session IV

Epidemiology, Infectious Disease, Intrapartum Fetal Assessment, Operative Obstetrics, Obstetric Quality & Safety, Public Health-Global Health

558 The association between maternal age and primary cesarean delivery in the U.S. between 1996 and 2004 Hung Key Nguyen1, Sanae Nakagawa2, Jonathan Snowden3, Aaron Caughey4, Yvonne W. Cheng5 1

Albert Einstein School of Medicine, School of Medicine, Bronx, NY, University of California, San Francisco, Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco, CA, 3Oregon Health and Sciences University, Obstetrics and Gynecology, Portland, OR, 4Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, 5University of California, San Francisco, Obstetrics & Gynecology, San Francisco, CA 2

OBJECTIVE: To examine regional difference in the annual incidence rate of primary cesarean delivery in the U.S. and the relationship between maternal age and cesarean delivery over time. STUDY DESIGN: This was a retrospective cohort study of non-anomalous, singleton, term, vertex live births by nulliparous women in the U.S. between 1996 and 2004 using Natality birth data. Deliveries were categorized by occurrence state into four regions* (Northeast[NE],

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Hyun Sun Ko , Yeun Hee Kim , Ki Cheol Kil , Hee Bong Moon2, Moon Young Kim3, Guisera Lee1, Sa Jin Kim1, Byung In Kim4, Jong Chul Shin1 1

Catholic University, Obstetrics and Gynecology, Seoul, Korea, 2Mizpark women’s hospital, Obstetrics and Gynecology, Hwasung-city, Kyunggi-do, Korea, 3Cheil General Hospital and Women’s Healthcare Center, Kwandong University College of Medicine, Obstetrics and Gynecology, Seoul, CT, Korea, 4In Jung hospital, Obstetrics and Gynecology, Seoul, Korea

OBJECTIVE: To estimate the prevalence and patterns of sleep disturbances among Korean pregnant and postpartum women.

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Midwest[MW], South[S], and West[W]). Time trend of primary cesarean associated with maternal age (stratified as ⬍35 vs. ⱖ35) was examined in 2-year intervals using chi-square test and multivariable logistic regression. Population based expected and observed number of cesarean over time was estimated using baseline cesarean risk and adjusted odds ratio. RESULTS: There were 7,259,585 live births meeting study criteria; of these, 20.6% had cesarean delivery. Compared to women ⫽35 had twice the adjusted odds of cesarean: 2.02 for NE, 2.08 for MW, 2.01 for S, and 2.33 for W. These odds ratios remained stable over the study period. The difference between observed and expected numbers of cesarean sections increased over time in all regions (see figure). CONCLUSION: While maternal age was a significant risk factor of cesarean delivery among nulliparous women, the magnitude of association remained relatively constant over time. The number of cesareans performed increasingly deviated from the expected effect accounted for by maternal age, suggesting that additional factors contributes to the current cesarean epidemic unexplained by maternal age alone.

STUDY DESIGN: This was a prospective, cohort study of Korean preg-

559 Sleep disturbances in Korean pregnant and postpartum women 1

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nant and postpartum women, who completed a sleep survey. The survey was composed of the following validated sleep questionnaires: Berlin Questionnaire for Sleep Disordered Breathing, Epworth Sleepiness Scale (ESS), Women’s Health Initiative Insomnia Rating Scale, the Pittsburgh Sleep Quality Index (PSQI), the International restless leg syndrome (IRLS) Study Group criteria, and the Johns Hopkins Telephone Diagnostic Interview Form (JHTDIF) for RLS. The ␹2 test, t-test and one-way ANOVA test were used to assess the univariate relationships between the parameters of sleep disturbance and the baseline characteristics. A logistic regression was used to analyze the influencing factors on sleep disturbances.

American Journal of Obstetrics & Gynecology Supplement to JANUARY 2012