Trends in risk factors for caesarean sections in France between 1981 and 1995: lessons for reducing the rates in the future

Guihard, Pierre; Blondel, Béatrice

doi:10.1111/j.1471-0528.2001.00009.x

Cited by 50 publications

(51 citation statements)

References 36 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The electronic fetal monitoring which is commonly used to detect fetal distress is known to have poor specificity resulting in increased in number of cesarean sections carried out for fetal distress. 2,13,15,16 Fear of litigation increases the use of continuous fetal monitoring and intervention early in labour. 17,18 In contrast to other studies where cesarean section rates were proportional to increase in maternal age, in our study 41.5 percent belonged to age group 25-29 years.…”

Section: Observationmentioning

confidence: 99%

Study of Primary Caesarean Section in Multiparous Women

Rao¹,

Rampure²

2013

jemds

View full text Add to dashboard Cite

OBJECTIVES:It is a study of the analysis of cases where caesarean section was done for the first time in parous women who had previous vaginal delivery of a viable neonate. The various indications, incidence according to age, gravidity, maternal and fetal outcome were studied. METHODS: It is a prospective study of over 200 cases of caesarean section done for the first time in parous women admitted at Government General Hospital, Basaveshwar Teaching and General Hospital, Sangameshwar Hospital, Gulbarga for a period of 18 months. RESULTS: The primary caesarean section rate was 10.28 percent. Maximum incidence of caesarean section was seen in the age group of 25-29 years and majority belonged to second and third gravid. 68 percent of women did not receive any antenatal care. Malpresentation, ante partum haemorrhage, CPD and fetal distress were most common indications for caesarean section. Post operative morbidity was seen in 14 percent of cases. There was no maternal mortality seen. Perinatal mortality rate was 105 for 1000 live births. CONCLUSIONS: It is clear from our study that Primary caesarean section in parous women is not uncommon. Though to a small extent, they are contributing to rise is total caesarean section rates seen. A parous woman needs good obstetric care to improve maternal and neonatal outcome and still keeping caesarean section to a lower rate. KEY WORDS: caesarean section, parous women, multiparous INTRODUCTION:There is worldwide increase in caesarean section rates. 1,2 Chile and Brazil have the highest caesarean section rates in the world being 40% and 37% respectively. 3 Mean caesarean rate in Asia is estimated to be 15.9% and 17.8% in respectively. 2 Most of the studies on caesarean section on parous women with previous normal delivery dates back to 1960's and 1970's where cesarean rates were low as 2.5-11.3% annually. 4,5,6,7,8,9,10 A recent study has demonstrated that the primary cesarean rate in 2002 was 13.3% among parous women as compared to 18% among nuliparous women in United States. 4 The relative ease with which some multiparous are delivered in the presence of faulty positions and presentations may account for the false sense of security. 11 The limited research in this area may be due to this false notion. It is for these reasons, we have examined trends in primary cesarean rates among parous women with previous normal vaginal delivery with respect to indications, maternal age and parity and the outcome.

show abstract

Section: Observationmentioning

confidence: 99%

Study of Primary Caesarean Section in Multiparous Women

Rao¹,

Rampure²

2013

jemds

View full text Add to dashboard Cite

show abstract

“…In the United States, 1 of 20 babies was delivered by cesarean section during the 1970's, with this rate reaching 1 in 4 during the 1990's (1). In France, an increase in cesarean sections from 10.7% in 1981 to 15.3% in 1995 was observed (2). In Brazil, the rate of cesarean sections increased from 15.6% in 1970 to 31.0% in 1980 (3) and from 31.6% in 1986 to 36.4% in 1996 (4).…”

Section: Introductionmentioning

confidence: 99%

Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?

Ribeiro

Figueiredo

Silva

et al. 2007

Braz J Med Biol Res

View full text Add to dashboard Cite

The objective of the present study was to investigate factors associated with cesarean sections in two cities located in different regions of Brazil and to determine factors that explain the higher cesarean section rate in the more developed city, Ribeirão Preto, compared to the less developed one, São Luís. Data from two cohort studies comprising 2846 women in Ribeirão Preto in 1994, and 2443 women in São Luís in 1997/1998 were used. Adjusted and non-adjusted risk estimates were calculated using a Poisson regression model. The cesarean section rate was 33.7% in São Luís and 50.8% in Ribeirão Preto. Adjusted analysis in a joint sequential model revealed a 51% higher risk of cesarean section in Ribeirão Preto compared to São Luís (prevalence rate ratio (PRR) = 1.51). Adjustment for category of hospital admission reduced the PRR to 1.09, i.e., this variable explained 82% of the difference in the cesarean section rate between the two cities. Adjustment for the variable "the same physician for prenatal care and delivery" reduced the PRR to 1.07, with the "physician" factor explaining 86% of the difference between rates. When simultaneously adjusted for the two variables, the PRR decreased to 1.05, with these two variables explaining 90% of the difference in the cesarean section rate between the two cities, and the difference was no longer significant. The difference in the cesarean section rate between the two Brazilian cities, one more and one less developed, was mainly explained by the physician factor and, to a lesser extent, by the category of hospital admission.

show abstract

“…Assim, nos Estados Unidos, de 1978 a 1986, variou de 14 a 28,8% 1 , taxa que foi classificada como alta, quando comparada a outros países da Europa e do Pacífico, ao longo de 13 anos. No mesmo período, o crescimento do número de cesáreas na Europa foi bem menor 11 . De modo análogo, a incidência de cesárea tem crescido no Brasil, tanto assim que há 30 anos, foi o país considerado o campeão de cesárea.…”

Section: Discussionunclassified

“…O desejo de reverter o aumento nas taxas de cesariana e tentar situá-las em níveis mais próximos daqueles que se podem considerar adequados exige revisão das condutas naquelas indicações que mais contribuíram para que a incidên-cia dos partos operatórios atingisse os valores registrados 6 . Outra estratégia é analisar a tendên-cia da incidência de cesárea de acordo com os fatores de riscos clínicos e não clínicos para cesárea 11 . Desta forma, pode-se determinar o impacto das mudanças na distribuição dos fatores de risco e daquelas na prática médica para cada ní-vel de risco 11 .…”

unclassified

See 1 more Smart Citation

Análise dos fatores de risco anteparto para ocorrência de cesárea

Silva¹,

Filho²,

Costa³

2005

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

RESUMOObjetivos: criar um modelo preditivo para ocorrência de cesárea na Maternidade Professor Monteiro de Morais após avaliação dos fatores de risco anteparto das gestantes que pariram no período de 1 de setembro de 1999 a 31 de agosto de 2000, e posteriormente verificar a eficiência do serviço na indicação de cesárea. Métodos: foi realizado estudo longitudinal, do tipo caso-controle com 3626 gestantes, no qual se verificou quais os fatores anteparto foram considerados de risco para cesárea, no período de 1 de setembro de 1999 a 31 de agosto de 2000. Posteriormente, criou-se modelo preditivo ideal, o qual permitiu quantificar o risco de cesárea para cada paciente na presença de um ou mais fatores de risco. A seguir, aplicou-se o modelo à amostra do estudo a fim de verificar o grau de concordância entre o risco previsto de cesárea e a realização do ato cirúrgico, ou seja, a eficácia na indicação de cesariana. Resultados: aplicando-se o modelo preditivo na amostra, verificou-se que na ausência dos fatores de riscos anteparto, o risco basal de cesárea foi de 15,2%. O grau de concordância entre o previsto pelo modelo logístico e a ocorrência de cesárea foi de 86,6%. Conclusões: o modelo logístico permitiu identificar o risco basal de cesárea e quantificar a probabilidade de cesárea a partir da introdução do fator de risco. O modelo pode ser considerado útil e eficaz, uma vez que houve concordância entre o acerto e o previsto em 86,6% para cesariana, e 53,6% das pacientes submetidas ao parto normal, de fato, não tinham fator de risco para cesárea. PALAVRAS-CHAVE: Cesárea; Resolução de problemas; Parto normal; Fatores de risco ABSTRACTPurpose: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. Methods: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. Results: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. Conclusions: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.

show abstract

Trends in risk factors for caesarean sections in France between 1981 and 1995: lessons for reducing the rates in the future

Cited by 50 publications

References 36 publications

Study of Primary Caesarean Section in Multiparous Women

Study of Primary Caesarean Section in Multiparous Women

Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?

Análise dos fatores de risco anteparto para ocorrência de cesárea

Contact Info

Product

Resources

About