Caesarean birth rates in public and privately funded hospitals: a cross-sectional study.

Autor:	Alonso BD; Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Saúde Pública. São Paulo, SP, Brasil., Silva FMBD; Universidade de São Paulo. Faculdade de Saúde Pública. Escola de Artes, Ciências e Humanidades. Departamento de Saúde Materno-Infantil. Graduação em Obstetrícia. São Paulo, SP, Brasil., Latorre MDRDO; Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil., Diniz CSG; Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Saúde Materno-Infantil. São Paulo, SP, Brasil., Bick D; King's College London. Florence Nightingale Faculty of Nursing and Midwifery. London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Revista de saude publica [Rev Saude Publica] 2017; Vol. 51, pp. 101. Date of Electronic Publication: 2017 Nov 17.
DOI:	10.11606/S1518-8787.2017051007054
Abstrakt:	Objective: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. Methods: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. Results: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women's maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. Conclusions: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
Databáze:	MEDLINE
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