Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12 944 women in England

Patel, Roshni; Peters, Tim J.; Murphy, Deirdre J.

doi:10.1093/ije/dyh401

Cited by 120 publications

(101 citation statements)

References 27 publications

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“…Apesar do estudo não ter investigado patologia específica, este conceito já está bem consolidado na prática obstétrica 27,28,29 , em particular a associação com diabetes (prévia ou gestacional) 14,29,30 .…”

Section: Discussionunclassified

Fatores médicos e não-médicos associados às taxas de cesariana em um hospital universitário no Sul do Brasil

2008

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O objetivo deste estudo foi descrever fatores associados ao aumento nas taxas de cesariana em um hospital universitário de 2002 e 2004, explorando a contribuição de fatores médicos e não-médicos para este aumento. Um estudo transversal investigou 2.905 partos ocorridos nos anos de 2002 (1.441) e 2004 (1.464). Diferenças nas razões de prevalência ajustadas pela regressão de Poisson e risco atribuível percentual foram estimados para a associação de cesariana com fatores sócio-demográficos; clínicos e reprodutivos; e do parto, institucionais e da prática obstétrica. As taxas de cesariana aumentaram de 28,4% em 2002 para 36,7% em 2004. Escolaridade materna elevada, hora do parto, presença de patologia e maior freqüência ao pré-natal foram os fatores que representaram a contribuição mais expressiva para o excesso em 2004, quando comparado a 2002. O aumento nas taxas de cesariana ao se comparar os dois anos pode ser atribuído, pelo menos em parte, a um crescimento nas indicações relativas e condições não-médicas.

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Section: Discussionunclassified

Fatores médicos e não-médicos associados às taxas de cesariana em um hospital universitário no Sul do Brasil

2008

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“…On the other hand, it is possible that increased use of antenatal services leads to increased medicalization of the pregnancy, including a greater openness to caesarean delivery. Overall, routine sonography in late pregnancy has not been shown to improve perinatal mortality 27 and there is limited sensitivity and specificity for 28 it is impossible to avoid the effect of physician preference in the face of specific clinical circumstances.…”

Section: Research Delivery Settings and Caesarean Section Rates In Chmentioning

confidence: 99%

Delivery settings and caesarean section rates in China

Sufang¹,

Padmadas

Zhao

et al. 2007

Bull World Health Organ

113

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Objective To quantify the influence of increasing use of health-care services on rising rates of caesarean section in China. Methods We used data from a population-based survey conducted by the United Nations Population Fund during September 2003 in 30 selected counties in three regions of China. The study sample (derived from birth history schedule) consisted of 3803 births to mothers aged less than 40 years between 1993 and 2002. Multiple logistic regression models were used to estimate the effect of health-care factors on the odds of a caesarean section, controlling for time and selected variables. Findings Institutional births increased from 53.5% in 1993-1994 to 82.2% in 2001-2002, while the corresponding increase in births by caesarean section was from 8.9% to 24.8%, respectively. Decomposition analysis showed that 69% of the increase in rates of caesarean section was driven by the increase in births within institutions. The adjusted odds of a caesarean section were 4.6 times (95% confidence interval, CI: 3.4-11.8) higher for recent births. The adjusted odds were also significantly higher for mothers who had at least one antenatal ultrasound test. Rates of caesarean section in secondary-level facilities markedly increased over the last decade to the same levels as in major hospitals (P < 0.001). Conclusion The upsurge in rates of births by caesarean section in this population cannot be fully explained by increases in institutional births alone, but is likely to be driven by medical practice within secondary-level hospitals and women's demand for the procedure. Une traduction en français de ce résumé figure à la fin de l´article. Al final del artículo se facilita una traducción al español.

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“…7 In a study from England Patel et al, found similar risk factors but with a variation between institutions and concluded that a careful exploration of risk factors may allow us to identify reasons for the increasing rates of caesarean section and the marked variation between institutions. 8 The strength of present study was its novelty (not many such studies are available), the population size, heterogeneity and absence of confounding factors for rate of caesarean e.g. money and insurance.…”

Section: Discussionmentioning

confidence: 99%

Antenatal risk factors in emergency caesarean sections done for fetal distress

Kohli

Singh

Dey

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Fetal distress is an important indication for emergency caesarean deliveries. The objective of this study is to identify the antenatal and intrapartum risk factors in emergency caesareans done for non-reassuring fetal status and compare with patients who underwent emergency caesareans for other indications.Methods: It was a retrospective study and data was collected from the labour room records of a tertiary care hospital. Patients undergoing emergency caesareans for fetal distress were the cases and the remaining emergency caesareans were the controls. Data was statistically analyzed.Results: There were 5184 deliveries during this period of which, 669 were emergency caesareans. 126 (18.83%) of these were due to fetal distress/ non-reassuring fetal status and 543 (81.17%) were for other indications. Caesarean due to fetal distress accounted for 2.43% of the total deliveries. There were more primigravidae (61.11% Vs 46.04%) in the fetal distress group (Odds Ratio 1.84, p=0.003). Intra uterine growth restriction (OR 5.44, p<0.0001) and antepartum haemorrhage mainly due to abruption (OR 11.19, p <0.0001) were other important antenatal risk factors. Those with neonates of birth weight between 1.5 to 2.0 kgs were more likely to undergo emergency caesarean for fetal distress (OR 1.78, p=0.0435). The risk of a lower APGAR was higher in the fetal distress group (12.59%). 28.34% neonates in this group required NICU admission.Conclusions: Primiparity, intrauterine growth restriction, antepartum hemorrhage and prematurity, have shown to significantly increase the risk of emergency cesareans due to non-reassuring fetal status. We need to improve antenatal care with a goal of early detection of the above risk factors for timely institution of appropriate intervention and thus contributing to a reduction of emergency caesareans due to fetal distress.

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Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12 944 women in England

Abstract: A careful exploration of risk factors may allow us to identify reasons for the increasing rates of Caesarean section and the marked variation between institutions.

Cited by 120 publications

References 27 publications

Fatores médicos e não-médicos associados às taxas de cesariana em um hospital universitário no Sul do Brasil

Fatores médicos e não-médicos associados às taxas de cesariana em um hospital universitário no Sul do Brasil

Delivery settings and caesarean section rates in China

Antenatal risk factors in emergency caesarean sections done for fetal distress

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