Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates
Abstract Background The objectives of this analysis were to document trends in and risk factors associated with the cesarean birth rate in low- and middle-income country sites participating in the Global Network for Women’s and Children’s Health Research (Global Network). Methods This is a secondary...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-12-01
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| Series: | Reproductive Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12978-020-01021-7 |
| _version_ | 1818380678896549888 |
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| author | Margo S. Harrison Ana L. Garces Shivaprasad S. Goudar Sarah Saleem Janet L. Moore Fabian Esamai Archana B. Patel Elwyn Chomba Carl L. Bose Edward A. Liechty Nancy F. Krebs Richard J. Derman Patricia L. Hibberd Waldemar A. Carlo Antoinette Tshefu Marion Koso-Thomas Elizabeth M. McClure Robert L. Goldenberg |
| author_facet | Margo S. Harrison Ana L. Garces Shivaprasad S. Goudar Sarah Saleem Janet L. Moore Fabian Esamai Archana B. Patel Elwyn Chomba Carl L. Bose Edward A. Liechty Nancy F. Krebs Richard J. Derman Patricia L. Hibberd Waldemar A. Carlo Antoinette Tshefu Marion Koso-Thomas Elizabeth M. McClure Robert L. Goldenberg |
| author_sort | Margo S. Harrison |
| collection | DOAJ |
| description | Abstract Background The objectives of this analysis were to document trends in and risk factors associated with the cesarean birth rate in low- and middle-income country sites participating in the Global Network for Women’s and Children’s Health Research (Global Network). Methods This is a secondary analysis of a prospective, population-based study of home and facility births conducted in the Global Network sites. Results Cesarean birth rates increased uniformly across all sites between 2010 and 2018. Across all sites in multivariable analyses, women younger than age twenty had a reduced risk of cesarean birth (RR 0.9 [0.9, 0.9]) and women over 35 had an increased risk of cesarean birth (RR 1.1 [1.1, 1.1]) compared to women aged 20 to 35. Compared to women with a parity of three or more, less parous women had an increased risk of cesarean (RR 1.2 or greater [1.2, 1.4]). Four or more antenatal visits (RR 1.2 [1.2, 1.3]), multiple pregnancy (RR 1.3 [1.3, 1.4]), abnormal progress in labor (RR 1.1 [1.0, 1.1]), antepartum hemorrhage (RR 2.3 [2.0, 2.7]), and hypertensive disease (RR 1.6 [1.5, 1.7]) were all associated with an increased risk of cesarean birth, p < 0.001. For multiparous women with a history of prior cesarean birth, rates of vaginal birth after cesarean were about 20% in the Latin American and Southeast Asian sites and about 84% at the sub-Saharan African sites. In the African sites, proportions of cesarean birth in the study were highest among women without a prior cesarean and a single, cephalic, term pregnancy. In the non-African sites, groups with the greatest proportion of cesarean births were nulliparous women with a single, cephalic, term pregnancy and all multiparous women with at least one previous uterine scar with a term, cephalic pregnancy. Conclusion Cesarean birth rates continue to rise within the Global Network. The proportions of cesarean birth are higher among women with no history of cesarean birth in the African sites and among women with primary elective cesarean, primary cesarean after induction, and repeat cesarean in the non-African sites. |
| first_indexed | 2024-12-14T02:22:30Z |
| format | Article |
| id | doaj.art-93198ef759c043cebb3634923f239628 |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-12-14T02:22:30Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-93198ef759c043cebb3634923f2396282022-12-21T23:20:28ZengBMCReproductive Health1742-47552020-12-0117S311010.1186/s12978-020-01021-7Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth ratesMargo S. Harrison0Ana L. Garces1Shivaprasad S. Goudar2Sarah Saleem3Janet L. Moore4Fabian Esamai5Archana B. Patel6Elwyn Chomba7Carl L. Bose8Edward A. Liechty9Nancy F. Krebs10Richard J. Derman11Patricia L. Hibberd12Waldemar A. Carlo13Antoinette Tshefu14Marion Koso-Thomas15Elizabeth M. McClure16Robert L. Goldenberg17University of Colorado School of MedicineInstituto de Nutrición de Centroamérica y PanamáKLE Academy Higher Education and Research J N Medical CollegeAga Khan UniversityRTI InternationalMoi University School of MedicineLata Medical Research FoundationUniversity Teaching HospitalUniversity of North Carolina at Chapel HillIndiana School of Medicine, University of IndianaUniversity of Colorado School of MedicineThomas Jefferson UniversityBoston University School of Public HealthUniversity of Alabama at BirminghamKinshasa School of Public HealthEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentRTI InternationalDepartment of Obstetrics and Gynecology, Columbia University School of MedicineAbstract Background The objectives of this analysis were to document trends in and risk factors associated with the cesarean birth rate in low- and middle-income country sites participating in the Global Network for Women’s and Children’s Health Research (Global Network). Methods This is a secondary analysis of a prospective, population-based study of home and facility births conducted in the Global Network sites. Results Cesarean birth rates increased uniformly across all sites between 2010 and 2018. Across all sites in multivariable analyses, women younger than age twenty had a reduced risk of cesarean birth (RR 0.9 [0.9, 0.9]) and women over 35 had an increased risk of cesarean birth (RR 1.1 [1.1, 1.1]) compared to women aged 20 to 35. Compared to women with a parity of three or more, less parous women had an increased risk of cesarean (RR 1.2 or greater [1.2, 1.4]). Four or more antenatal visits (RR 1.2 [1.2, 1.3]), multiple pregnancy (RR 1.3 [1.3, 1.4]), abnormal progress in labor (RR 1.1 [1.0, 1.1]), antepartum hemorrhage (RR 2.3 [2.0, 2.7]), and hypertensive disease (RR 1.6 [1.5, 1.7]) were all associated with an increased risk of cesarean birth, p < 0.001. For multiparous women with a history of prior cesarean birth, rates of vaginal birth after cesarean were about 20% in the Latin American and Southeast Asian sites and about 84% at the sub-Saharan African sites. In the African sites, proportions of cesarean birth in the study were highest among women without a prior cesarean and a single, cephalic, term pregnancy. In the non-African sites, groups with the greatest proportion of cesarean births were nulliparous women with a single, cephalic, term pregnancy and all multiparous women with at least one previous uterine scar with a term, cephalic pregnancy. Conclusion Cesarean birth rates continue to rise within the Global Network. The proportions of cesarean birth are higher among women with no history of cesarean birth in the African sites and among women with primary elective cesarean, primary cesarean after induction, and repeat cesarean in the non-African sites.https://doi.org/10.1186/s12978-020-01021-7Cesarean birthLow- and middle-income countriesTrendsRisk factorsVaginal birth after cesareanRobson classification |
| spellingShingle | Margo S. Harrison Ana L. Garces Shivaprasad S. Goudar Sarah Saleem Janet L. Moore Fabian Esamai Archana B. Patel Elwyn Chomba Carl L. Bose Edward A. Liechty Nancy F. Krebs Richard J. Derman Patricia L. Hibberd Waldemar A. Carlo Antoinette Tshefu Marion Koso-Thomas Elizabeth M. McClure Robert L. Goldenberg Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates Reproductive Health Cesarean birth Low- and middle-income countries Trends Risk factors Vaginal birth after cesarean Robson classification |
| title | Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates |
| title_full | Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates |
| title_fullStr | Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates |
| title_full_unstemmed | Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates |
| title_short | Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates |
| title_sort | cesarean birth in the global network for women s and children s health research trends in utilization risk factors and subgroups with high cesarean birth rates |
| topic | Cesarean birth Low- and middle-income countries Trends Risk factors Vaginal birth after cesarean Robson classification |
| url | https://doi.org/10.1186/s12978-020-01021-7 |
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