{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:20:59Z","timestamp":1787829659724,"version":"build-2784847793"},"reference-count":49,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005189","name":"Estonian Research Competency Council","doi-asserted-by":"publisher","award":["TT17"],"award-info":[{"award-number":["TT17"]}],"id":[{"id":"10.13039\/501100005189","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018693","name":"HORIZON EUROPE Framework Programme","doi-asserted-by":"publisher","award":["101120075"],"award-info":[{"award-number":["101120075"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cesarean section (CS) is the most common gynecological surgery globally, with rates increasing in many developed countries. In Estonia, the CS rate rose from 6.4% in 1992 to 20.6% in 2021. While CS can be lifesaving when medically necessary, its rising use without clear medical indication does not have benefits for the mother but is associated with a broad spectrum of long\u2010term complications, including uterine rupture, abnormal placentation, ectopic pregnancy, abnormal uterine bleeding, and chronic pelvic pain. The Estonian Biobank (EstBB) is a population\u2010based biobank that links genetic data with health records from national registries. Between 2007 and 2023, over 200\u2009000 individuals were recruited, providing a valuable dataset for health and genetics research. This study examines maternal health conditions occurring both before and after childbirth, including short\u2010 and long\u2010term outcomes associated with CS and vaginal delivery (VD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed EstBB health data using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD\u201010) codes to compare short\u2010 and long\u2010term maternal health conditions occurring before and after childbirth between women with one or more VD (ICD\u201010 O80,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930\u2009898) and women with one or more CS (ICD\u201010 O82,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098285). Women with a history of both VD and CS were excluded. Logistic regression assessed associations between delivery mode and health conditions, adjusting for maternal birth year and body mass index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>As expected, the CS group had higher rates of comorbidities and pregnancy complications like gestational diabetes, hypertensive disorders, mental health issues, and possible postsurgical morbidities such as infections, incisional hernia, and chronic pain. In the VD group, conditions like perineal trauma, pelvic organ prolapse, and stress urinary incontinence were more prevalent. Interestingly, cervical inflammatory conditions and cervical dysplasia were also more common in the VD group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CS is related to more complications and health problems compared with VD, but the relationship may not be causative. CS risks should be weighed against clinical indications for its use. It is important for healthcare providers to recognize and openly discuss both the immediate and long\u2010term risks associated with the procedure with women requiring or considering CS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70344","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:45:14Z","timestamp":1787827514000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delivery mode and maternal health conditions before and after childbirth: A population\u2010based cohort study from Estonia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0563-7620","authenticated-orcid":false,"given":"Katrin","family":"T\u00e4\u00e4r","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine University of Tartu  Tartu Estonia"},{"name":"Tartu University Hospital Women's Clinic  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle","family":"Karro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine University of Tartu  Tartu Estonia"},{"name":"Tartu University Hospital Women's Clinic  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merli","family":"Saare","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine University of Tartu  Tartu Estonia"},{"name":"Celvia CC  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reedik","family":"M\u00e4gi","sequence":"additional","affiliation":[{"name":"Estonian Genome Centre, Institute of Genomics University of Tartu  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Estonian Biobank Research Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Salumets","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine University of Tartu  Tartu Estonia"},{"name":"Celvia CC  Tartu Estonia"},{"name":"Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institute, and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Triin","family":"Laisk","sequence":"additional","affiliation":[{"name":"Estonian Genome Centre, Institute of Genomics University of Tartu  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maire","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Institute of Clinical Medicine University of Tartu  Tartu Estonia"},{"name":"Celvia CC  Tartu Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-005671"},{"key":"e_1_2_14_3_1","unstructured":"European Perinatal Health Report.Core indicators of the health and care of pregnant women and babies in Europe from 2015 to 2019. 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