
A retrospective cohort study across four hospitals (2016-2019) explored outcomes in women aged 40 and above during delivery. Unplanned cesarean sections were more prevalent in very advanced maternal age (45+) at 29.1%, compared to advanced maternal age (40-44) at 21.1%. Significant predictive factors included higher BMI, no previous vaginal delivery, spontaneous start of delivery, and days needed for cervical priming. A predictive model with a 0.75 AUC was established to predict unplanned cesarean sections. Nulliparous women showed additional risk factors, emphasizing the importance of personalized care in older pregnancies.
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