August 2nd, 2021

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Influence of Obstetrics Practice on Population Trends in Europe and Slovakia
Authors:  Jozef Zahumensky, M.D., Ph.D., Pavel Dolezal, M.D., Petra Psenkova, M.D., Marian Krizko, Jr., Ph.D., and Paula Drabiscakova, M.D.
  OBJECTIVE: To determine the correlation between cesarean section and fertility rates in selected countries and to find out the group of parturients, according to age and education, whose future fertility is most influenced by cesarean section in first pregnancy.

STUDY DESIGN: Data on fertility rate and cesarean section frequency for Europe-an countries were obtained from the Euro-Peristat data-base and statistically analyzed for year 2015. Slovak women giving birth for the first time in 2006 were analyzed, with data from the Slovak National Health Information Centre. Reappearance of these women in this registry by the year 2018 was traced, counted, and compared based on the mode of delivery.

RESULTS: A rise in the frequency of cesarean sections by 10% in European countries lowers the fertility rate by 0.102. First delivery by cesarean section in the studied group lowers the probability of second delivery (OR=0.68). In the group of women aged 26–30 years, the influence is most significant (OR=0.66); higher-educated women are most influenced (OR=0.58). The average number of subsequent children in the group of women under 30 years of age with vaginal delivery was 1.01, achieving replacement level fertility of a couple.

CONCLUSION: Delivery by cesarean section influences markedly the number of subsequent offspring.
Keywords:  cesarean section rate; fertility rate; Europe/epidemiology; healthcare disparities/statistics & numerical data; maternal-child health services/trends; population surveillance; practice patterns, physicians’; pregnancy; subsequent deliveries; vaginal delivery
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