{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:07:00Z","timestamp":1773299220795,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T00:00:00Z","timestamp":1489708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100015471","name":"Mater Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015471","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,8]]},"abstract":"Background<\/jats:title>In Australia, more than 20% of women giving birth are 35\u00a0years or older. Advanced maternal age (AMA<\/jats:styled-content>) is a risk factor for stillbirth, and many clinicians now recommend induction of labour (IOL<\/jats:styled-content>) at around term gestation. The aim of this study is to determine if AMA<\/jats:styled-content> is associated with emergency caesarean section (CS<\/jats:styled-content>) following IOL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>A retrospective cohort study was undertaken using routinely collected de\u2010identified data. Live\u2010born, singleton, cephalic, non\u2010anomalous pregnancies undergoing IOL<\/jats:styled-content> between 37\u00a0+\u00a00 and 42\u00a0+\u00a00\u00a0weeks were included. Previous CS<\/jats:styled-content> and privately insured admission status were excluded. Mode of delivery was compared for women \u226538\u00a0years (AMA<\/jats:styled-content>) and women <38\u00a0years. The primary outcome was birth by CS<\/jats:styled-content>. Bivariate and multivariate logistic regression analyses were\u00a0undertaken.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 7459 women were included (\u226538\u00a0years n<\/jats:italic>\u00a0=\u00a0718, 9.6%; <38\u00a0years n<\/jats:italic>\u00a0=\u00a06741, 90.4%). AMA<\/jats:styled-content> women had similar rates of unassisted vaginal births (OR<\/jats:styled-content> 1.15, 95% CI<\/jats:styled-content> 0.98\u20131.35, P<\/jats:italic>\u00a0=\u00a00.080) and CS<\/jats:styled-content> (OR<\/jats:styled-content> 1.08, 95% CI<\/jats:styled-content> 0.90\u20131.30, P<\/jats:italic>\u00a0=\u00a00.407) but fewer instrumental deliveries (OR<\/jats:styled-content> 0.69, 95% CI<\/jats:styled-content> 0.55\u20130.87, P<\/jats:italic>\u00a0=\u00a00.002) compared to women <38\u00a0years. When controlled for confounders, AMA<\/jats:styled-content> was independently associated with a two\u2010fold increase in birth by CS<\/jats:styled-content> following IOL<\/jats:styled-content> (adjusted OR<\/jats:styled-content> 2.29; 95% CI<\/jats:styled-content> 1.64\u20133.20; P<\/jats:italic>\u00a0<\u00a00.001). There were no differences in neonatal\u00a0outcomes.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Following IOL<\/jats:styled-content>, AMA<\/jats:styled-content> was associated with a two\u2010fold increased likelihood of birth by CS<\/jats:styled-content> in both nulliparous and multiparous women. However, the majority of AMA<\/jats:styled-content> women birthed vaginally. Clinicians may find this information useful when counselling older women who are undergoing term IOL<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12611","type":"journal-article","created":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T10:28:56Z","timestamp":1489746536000},"page":"426-431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Maternal age is a risk factor for caesarean section following induction of labour"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-9499","authenticated-orcid":false,"given":"Liam","family":"Dunn","sequence":"first","affiliation":[{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0832-4811","authenticated-orcid":false,"given":"Sailesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"},{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital Brisbane Queensland Australia"},{"name":"School of Medicine University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Mater Research Institute University of Queensland Brisbane Queensland Australia"},{"name":"Department of Obstetrics and Gynaecology Mater Mothers\u2019 Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,17]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"32","article-title":"Trends in fertility and contraception in the last quarter of the 20th century","volume":"100","author":"Botting B","year":"2000","journal-title":"Popul Trends"},{"key":"e_1_2_7_3_1","unstructured":"HilderL ZhichaoZ ParkerM JahanS ChambersGH.Australia's mothers and babies 2012. 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