Cesarean rates in a Chilean public hospital and the use of a new prioritization criteria: The relevance index

Yamamoto, M.; Latorre, Rodrigo; Rojas, Juan; Walker, Bernardita; Jordan, F.; Carrillo, J.; Paiva, E.; Insunza, A.

doi:10.1111/jog.13879

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…When analyzing the groups with the greatest contribution to the overall CS rate, our results are in agreement with other studies worldwide, in which multiparous women with a history of at least 1 previous CS, gestational age ≥ 37 weeks, and in cephalic presentation (Group 5) are among the main contributors, 9 ranging from 17.2% in South Africa 10 11 12 13 to 35.6% of all CSs in Colombia. 10 These findings suggest that interventions to reduce the CS rate need to be implemented in Group 5, aiming to ascertain a VBAC; nevertheless, at the same time, the most important action should be preventing the first CS in women of Groups 1 to 4.…”

Section: Discussionsupporting

confidence: 91%

Robson's Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction

Paz

Banegas²,

Luz

et al. 2022

Rev Bras Ginecol Obstet

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Objective To use the Robson Ten Group Classification (RTGC) to analyze cesarean section (CS) rates in a Honduran maternity hospital, with focus in groups that consider induction of labor. Methods Cross-sectional study. Women admitted for childbirth (August 2017 to October 2018) were classified according to the RTGC. The CS rate for each group and the contribution to the overall CS rate was calculated, with further analyses of the induction of labor among term primiparous (group 2a), term multiparous (group 4a), and cases with one previous CS (group 5.1). Results A total of 4,356 women were considered, with an overall CS rate of 26.1%. Group 3 was the largest group, with 38.6% (1,682/4,356) of the cases, followed by Group 1, with 30.8% (1,342/4,356), and Group 5, with 10.3% (450/4,356). Considering the contribution to overall CS rates per group, Group 5 contributed with 30.4% (345/1,136) of the CSs and within this group, 286/345 (82.9%) had 1 previous CS, with a CS rate > 70%. Groups 1 and 3, with 26.6% (291/1,136) and 13.5% (153/1,136), respectively, were the second and third larger contributors to the CS rate. Groups 2a and 4a had high induction success, with low CS rates (18.4 and 16.9%, respectively). Conclusion The RTGC is a useful tool to assess CS rates in different healthcare facilities. Groups 5, 1, and 3 were the main contributors to the CS rate, and groups 2 and 4 showed the impact and importance of induction of labor. These findings may support future interventions to reduce unnecessary CS, especially among primiparous and in women with previous CS.

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Section: Discussionsupporting

confidence: 91%

Robson's Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction

Paz

Banegas²,

Luz

et al. 2022

Rev Bras Ginecol Obstet

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“…Another Mexican study found an overall CSR ranging from 53.5 to 48.7% [ 15 ]. Only a Chilean facility-based study found lower rates (27%), despite drawing attention to the increase in C-sections in groups 1, 3 and 4, suggesting that in the following years the facility will probably face an increase in group 5 [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of maternal morbidity on cesarean section rates: exploring a Latin American network of sentinel facilities using the Robson’s Ten Group Classification System

Sosa,

de Mucio,

Colomar

et al. 2023

BMC Pregnancy Childbirth

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Background Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson’s Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. Methods Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. Results Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). Conclusion Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR.

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“…Although birth timing is not consistently a modifiable risk factor, elective caesarean section can be. Elective caesarean sections are increasing in frequency in many countries 11,22‐24 due to multiple factors including convenience, reimbursement rates and patient request. This knowledge of the specific increased risk for the infants may aid in physician‐patient discussions about reducing elective caesarean sections during particular seasons.…”

Section: Discussionmentioning

confidence: 99%

Elective caesarean section and bronchiolitis hospitalization: A retrospective cohort study

Douglas

Leventer‐Roberts

Levinkron

et al. 2020

Pediatric Allergy Immunology

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Background We sought to evaluate whether elective caesarean section is associated with subsequent hospitalization for bronchiolitis. Methods This is a retrospective cohort study that used the electronic medical record database of Clalit Health Services, the largest healthcare fund in Israel, serving over 4.5 million members and over half of the total population. The primary outcome was bronchiolitis admission in the first 2 years of life. We performed logistic regression analyses to identify independent associations. We repeated the analysis using boosted decision tree machine learning techniques to confirm our findings. Results There were 124 553 infants enrolled between 2008 and 2010, and 5168 (4.1%) were hospitalized for bronchiolitis in the first 2 years of life. In logistic regression models stratified by seasons, elective caesarean section birth was associated with 15% increased odds (95% CI: 1.02‐1.30) for infants born in the fall season, 28% increased odds (95% CI: 1.11, 1.47) for those born in the winter, 35% increased odds (95% CI: 1.12‐1.62) for those born in the spring and 37% increased odds (95% CI: 1.18‐1.60) for those born in the summer. In the boosted gradient decision tree analysis, the area under the curve for risk of bronchiolitis admission was 0.663 (95% CI: 0.652, 0.674) with timing of birth as the most important feature. Conclusion Elective caesarean section, a potentially modifiable risk factor, is associated with increased odds of hospitalization for bronchiolitis in the first 2 years of life. These data should be considered when scheduling elective caesarean sections especially for infants born in spring and summer months.

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Cesarean rates in a Chilean public hospital and the use of a new prioritization criteria: The relevance index

Cited by 4 publications

References 23 publications

Robson's Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction

Robson's Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction

The impact of maternal morbidity on cesarean section rates: exploring a Latin American network of sentinel facilities using the Robson’s Ten Group Classification System

Elective caesarean section and bronchiolitis hospitalization: A retrospective cohort study

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