{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T22:58:32Z","timestamp":1778540312220,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T00:00:00Z","timestamp":1655078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is widespread concern around the rising rates of cesarean births (CBs), especially among first\u2010time mothers, despite evidence suggesting increased morbidities after birth by cesarean. There are uncertainties around factors associated with rising rates of CBs among first\u2010time mothers in Ireland, and insight into these is essential for understanding the rising trend in CBs. Therefore, this study aimed to identify the factors associated with CBs in nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was conducted in three maternity hospitals in the Republic of Ireland between 2012 and 2017. Data were collected from 3047 nulliparous women using self\u2010administered surveys antenatally and at 3\u2009months postpartum and from consenting women\u2019s hospital records (n\u00a0=\u00a02755) and analyzed using the Poisson regression to assess associations between demographic and clinical factors and the main outcome measures, planned and unplanned CBs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Common risk factors for planned and unplanned CBs were being aged \u226540\u2009years, being in private care, multiple pregnancy, and fetus in breech or other malpresentations. An unplanned CB occurred for 22.43% (n\u00a0=\u00a0377\/1681) of women who did not have induction of labor (IOL) or who had IOL with no epidural, but the risk was about twice as high for women who had IOL and epidural.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings confirm multifactorial reasons for CB and the challenge of reversing the increasing CB rate if maternal age, overweight\/obesity, infertility treatment, multiple pregnancy, and preexisting hypertension in Ireland continue to increase. There is a need to address prelabor interventions, especially IOL combined with epidural analgesia with respect to unplanned CB.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12654","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T09:19:19Z","timestamp":1655111959000},"page":"812-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Factors associated with cesarean birth in nulliparous women: A multicenter prospective cohort study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2308-1045","authenticated-orcid":false,"given":"Sunita","family":"Panda","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery Trinity College Dublin  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecily","family":"Begley","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Trinity College Dublin  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Corcoran","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Centre University College Cork  Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deirdre","family":"Daly","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Trinity College Dublin  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148343"},{"key":"e_1_2_8_3_1","unstructured":"Euro\u2010Peristat Project.European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015.2018.http:\/\/www.europeristat.com. Accessed March 10 2021."},{"key":"e_1_2_8_4_1","unstructured":"McMahonL McGraneK McKennaP TurnerM.National Women and Infants Health Programme (NWIHP) Clinical Programme for Obstetrics and Gynaecology. Irish Maternity Indicator System (IMIS) National Report 2019. National Women and Infants. Health Programme for Obstetrics and Gynaecology Ireland.2020.https:\/\/www.hse.ie\/eng\/about\/who\/acute\u2010hospitals\u2010division\/woman\u2010infants\/national\u2010reports\u2010on\u2010womens\u2010health\/imis\u2010national\u2010report\u20102019.pdf. 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