The Association of Maternal Occupations and Deliveries by Cesarean Section for Infants Born in Washington, 2011 to 2013

Nearly one-third of all pregnancies in the United States are surgically delivered by cesarean, which has a higher rate of maternal complications compared to vaginal delivery. There are national campaigns to reduce the number of cesarean sections in low-risk pregnancies, which are defined as nulliparous, vertex, singleton, and term (NVST). The objective for this study was to determine the effect of maternal occupations and risk of cesarean delivery in low risk pregnancies. A population-based, retrospective cohort study was conducted using Washington State birth certificate records for the years 2011 through 2013. This study analyzes the association between maternal exposure of non-agricultural occupations (n = 1259) and the outcome of cesarean delivery compared with maternal agricultural occupations (n = 193) and cesarean delivery for low-risk pregnancies. Logistic regression revealed that women working in non-agricultural occupations had a 1.33 (95% confidence interval (CI): 0.87-2.01) higher odds for cesarean delivery than women working in agricultural occupations in Washington from 2011-2013 (p = 0.18). Although no significant association was found between maternal occupations and cesarean delivery, future studies should investigate other potential associations to include advanced maternal age and cesarean delivery as well as prenatal insurance and cesarean delivery.