{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:05:52Z","timestamp":1787317552967,"version":"build-2736575974"},"reference-count":55,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Caesarean section (C-section) rates in Mexico have risen dramatically over the past decade, reaching 55% by 2023. While life-saving when correctly indicated, excessive use may alter the natural timing of childbirth and shift population-level birth outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To examine national trends in gestational age, birth weight and birth length from 2010 to 2023, and evaluate their association with mode of delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Population-based repeated cross-sectional analysis using national birth certificate data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We analysed a 1-in-1000 random sample of birth certificates from Mexico\u2019s national registry (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200927,435) for 2010\u20132023. Fractional polynomial models assessed national trends in birth outcomes by delivery type. Multivariable linear regressions adjusted for maternal age, parity, schooling and year of birth. Marginal effects were used to examine changes in C-section rates by maternal age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The C-section rate rose from 45% in 2010 to 55% in 2023. Over the same period, full-term births (\u2a7e39\u2009weeks) declined from 66.5% to 57.7%, while early-term births (37\u201338\u2009weeks) rose from 26.6% to 34.2%. Gestational age declined over time for both vaginal and C-section deliveries. A sharp rise in C-section rates beginning around 2015 coincided with abrupt downward trends in gestational age, birth weight, and length across delivery modes. In adjusted models, birth by C-section was associated with a reduction of 0.5\u2009weeks in gestational age at birth (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increased risk of prematurity (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u20090.053,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and reductions in birth weight (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u221221.04\u2009g,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001) and length (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.41\u2009cm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), compared to vaginal delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The rising prevalence of C-sections in Mexico aligns with a broader shift towards earlier deliveries, driven primarily by an increase in early-term births. This shift affects both surgical and spontaneous deliveries and may have long-term implications for children health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251399895","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:04:22Z","timestamp":1764306262000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of excessive caesarean deliveries on gestational age at birth in Mexico: National-level trends, 2010\u20132023"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-8399","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Lamadrid-Figueroa","sequence":"first","affiliation":[{"name":"Department of Perinatal Health, National Institute of Public Health, Cuernavaca, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4157-5981","authenticated-orcid":false,"given":"Jimena","family":"Fritz","sequence":"additional","affiliation":[{"name":"Centre for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. 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