Evaluation of cesarean delivery rates and factors associated with cesarean delivery among women enrolled in a pregnancy cohort study at two tertiary hospitals in Thailand

Autor: Orada Patamasingh Na Ayudhaya, Wanitchaya Kittikraisak, Podjanee Phadungkiatwatana, Danielle Rentz Hunt, Krissada Tomyabatra, Tawee Chotpitayasunondh, Romeo R. Galang, Karen Chang, Tana Brummer, Lunthaporn Puttanavijarn, Parker Malek, Fatimah S. Dawood, Joshua A. Mott, for the PRIME Study Group
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Pregnancy and Childbirth, Vol 24, Iss 1, Pp 1-13 (2024)
Druh dokumentu: article
ISSN: 1471-2393
DOI: 10.1186/s12884-024-06314-4
Popis: Background Cesarean delivery rates have increased globally resulting in a public health concern. We estimate rates of cesarean deliveries among Thai women using the World Health Organization (WHO) Robson Classification system and compare rates by Robson group to the Robson guideline for acceptable rates to identify groups that might benefit most from interventions for rate reduction. Methods In 2017 and 2018, we established cohorts of pregnant women aged ≥ 18 years seeking prenatal care at two tertiary Thai hospitals and followed them until 6–8 weeks postpartum. Three in-person interviews (enrollment, end of pregnancy, and postpartum) were conducted using structured questionnaires to obtain demographic characteristics, health history, and delivery information. Cesarean delivery indication was classified based on core obstetric variables (parity, previous cesarean delivery, number of fetuses, fetal presentation, gestational week, and onset of labor) assigned to 10 groups according to the Robson Classification. Logistic regression was used to identify factors associated with cesarean delivery among nulliparous women with singleton, cephalic, term pregnancies. Results Of 2,137 participants, 970 (45%) had cesarean deliveries. The median maternal age at delivery was 29 years (interquartile range, 25–35); 271 (13%) participants had existing medical conditions; and 446 (21%) had pregnancy complications. The cesarean delivery rate varied by Robson group. Multiparous women with > 1 previous uterine scar, with a single cephalic pregnancy, ≥ 37 weeks gestation (group 5) contributed the most (14%) to the overall cesarean rate, whereas those with a single pregnancy with a transverse or oblique lie, including women with previous uterine scars (group 9) contributed the least (
Databáze: Directory of Open Access Journals
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