Prevalence and Determinants of Caesarean Section in South and South-east Asian Women

Abstract

Background: Caesarean section is considered a preferable and safe method of delivery. In the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-east Asia (the third highest populated region), the preference for, and variation in, caesarean section delivery and its associated maternal socioeconomic characteristics are still to be determined.Objective: To study the magnitude of caesarean delivery in the South and South-east Asian countries, by correlating the maternal socioeconomic characteristics with the preference for caesarean sections.Methodology: Data on ever-married women of nine developing countries of South and South-east Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh and Cambodia, from Demographic and Health Survey has considered. Both bivariate and multivariate binary logistic regression models were used to estimate the probability that a woman undergoes caesarean section and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean section. Conclusion:In seven urban and four rural regions of nine South and South-East Asian countries, a significant inclination towards the caesarean delivery above the more recent outdate WHO recommended optimal range of 10-15% or the more recent study by top researchers of 19% has been found. The analysis confirmed that the prevalence of caesarean section and its associated maternal socioeconomic characteristics varied widely among these nine South and South-East Asian countries.

Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review

“…For example, Poudel et al (2020) 17 reported that the pooled stillbirth rate in India, Bangladesh, Nepal and Pakistan was 25.15 per 1,000 births. Another study reported that, the prevalence of C‐section delivery is around 13% in South Asian countries 19 . Although several studies have pointed the association between GDM and adverse pregnancy outcomes, it is important that these findings are synthesized systematically to provide concrete evidence for policymakers and practitioners in South Asia.…”

“…Another study reported that, the prevalence of C-section delivery is around 13% in South Asian countries. 19 Although several studies have pointed the association between GDM and adverse pregnancy outcomes, it is important that these findings are synthesized systematically to provide concrete evidence for policymakers and practitioners in South Asia. This study aimed to synthesize the evidence on the association between GDM and adverse pregnancy outcomes in South Asian countries.…”

Prevalence and Factors Associated With Caesarean Delivery in Nepal: Evidence From a Nationally Representative Sample

“…For instance, in Bangladesh [ 17 ], the CS rate increased eight-fold from 2004 to 2017/8 with a four-fold increase in Nepal [ 12 , 18 ] between 2001 and 2011, with this trend continuing [ 12 , 17 - 18 ]. Previous studies found that CS delivery was higher among urban women, primarily educated women, than rural, uneducated women [ 9 , 11 , 18 - 22 ]. As the rate of CS delivery in private hospitals was significantly higher than in government hospitals among South and Southeast Asian women, only women from wealthy groups could afford the high cost and quickly decided for CS [ 9 , 23 - 26 ].…”

“…Previous studies found that CS delivery was higher among urban women, primarily educated women, than rural, uneducated women [ 9 , 11 , 18 - 22 ]. As the rate of CS delivery in private hospitals was significantly higher than in government hospitals among South and Southeast Asian women, only women from wealthy groups could afford the high cost and quickly decided for CS [ 9 , 23 - 26 ].…”

“…The mother's residence, especially in low- and middle-income countries (LMICs), appreciably impacts CS rates, increasing mothers in urban areas [ 9 , 46 ]. The level of education also appears to influence CS rates, with typically higher education levels associated with higher CS prevalence rates [ 1 , 13 , 15 ].…”