Early and late puerperal complications associated with the mode of delivery in a cohort in Brazil.

INTRODUCTION

The rates of cesarean section births significantly increased in Brazil and worldwide in recent years; and along with them, the interest in studying the complications related to this procedure.

OBJECTIVE

To assess the early and late maternal complications associated with the mode of delivery in up to six years after labor.

METHODS

This is a prospective cohort study that followed all births in the city of Pelotas, in Southern Brazil (4,244 mothers) in 2004, for a period of 6 years. Descriptive analyses and the association between the outcome and mode of delivery were performed. The control for potential confounding factors was performed using Poisson regression with robust error variance.

RESULTS

About half (44.9%) of the women underwent cesarean section. Cesarean sections were associated with a 56% higher risk of early complications, 2.98 times higher risk of postpartum infection, 79% higher risk of urinary tract infection, 2.40 times higher risk of pain, 6.16 times higher risk of headaches, and 12 times higher risk of anesthetic complications compared to the vaginal delivery. Cesarean section was a protection factor against the presence of hemorrhoids. The mode of delivery was not associated with any of the late complications studied.

CONCLUSIONS

Due to the risk of associated complications, cesarean sections should be performed with caution, when their benefits outweigh the risks.