{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:40:47Z","timestamp":1789962047981,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000031","name":"Institute of Human Development, Child and Youth Health","doi-asserted-by":"publisher","award":["MFM \u2013 146444"],"award-info":[{"award-number":["MFM \u2013 146444"]}],"id":[{"id":"10.13039\/501100000031","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Caesarean section (CS) is more common following infertility treatment (IT) but the reasons why remain unclear and confounded. The Robson 10\u2010Group Classification System (TGCS) may further explain variation in CS rates. We assessed the association between mode of conception and CS across Robson groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Ontario, Canada, in a public healthcare system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>921\u2009023 births, 2006\u20132014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Modified Poisson regression produced relative risks (RR) and 95% confidence intervals, comparing the risk of CS among women with (1) subfertility without IT, (2) non\u2010invasive IT (OI, IUI) or (3) invasive IT (IVF)\u2014each relative to (4) spontaneous conception (SC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>CS rate according to one of four modes\u2009of conception, overall and stratified by each of the TGCS groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Relative to SC (26.9%), the risk of CS increased in those with subfertility without IT (RR 1.17, 95% CI 1.16\u20131.18), non\u2010invasive IT (RR 1.21, 95% CI 1.18\u20131.24) and invasive IT (RR 1.39, 95% CI 1.36\u20131.42). Within each Robson group, similar patterns of RRs were seen, but with markedly differing rates. For example, in Group 1 (nulliparous, singleton, cephalic at \u226537\u2009weeks, with spontaneous labour), the respective rates were 15.0, 19.4, 18.7 and 21.9%; in Group 2 (nulliparous, singleton, cephalic at \u226537\u2009weeks, without spontaneous labour), the rates were 35.9, 44.4, 43.2 and 54.1%; and in Group 8 (multiple pregnancy), they were 55.9, 67.5, 65.0 and 69.3%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CS is relatively more common in women with subfertility and those receiving IT, an effect that persists across Robson groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Caesarean delivery is more common in women with infertility independent of demographics and prenatal conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17019","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T17:48:40Z","timestamp":1637344120000},"page":"908-916","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Caesarean birth in women with infertility: population\u2010based cohort study"],"prefix":"10.1111","volume":"129","author":[{"given":"E","family":"Richmond","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Kingston General Hospital Queen\u2019s University  Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JG","family":"Ray","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"},{"name":"Department of Medicine St. Michael\u2019s Hospital University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pudwell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Kingston General Hospital Queen\u2019s University  Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Djerboua","sequence":"additional","affiliation":[{"name":"ICES  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Gaudet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Kingston General Hospital Queen\u2019s University  Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology &amp; Newborn Care University of Ottawa  Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GN","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Kingston General Hospital Queen\u2019s University  Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4834-8279","authenticated-orcid":false,"given":"MP","family":"Velez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Kingston General Hospital Queen\u2019s University  Kingston ON Canada"},{"name":"ICES  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"3","article-title":"Seeking medical help to conceive","volume":"23","author":"Statistics Canada","year":"2012","journal-title":"Health Rep"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu067"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-017-4379-8"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.04.032"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des347"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03938-8"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05593-4"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03711-x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30992-0"},{"key":"e_1_2_7_11_1","unstructured":"Inpatient hospitalization surgery and newborn statistics 2018\u20132019.Canadian Institute for Health Information.2020[www.cihi.ca\/en\/access\u2010data\u2010reports\/results?query=caesarean+section&Search+Submit=]. 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