Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?
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,...
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| Format: | Article |
| Language: | English |
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Associação Brasileira de Divulgação Científica
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| Series: | Brazilian Journal of Medical and Biological Research |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008&lng=en&tlng=en |
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| author | V.S. Ribeiro F.P. Figueiredo A.A.M. Silva H. Bettiol R.F.L. Batista L.C. Coimbra Z.C. Lamy M.A. Barbieri |
| author_facet | V.S. Ribeiro F.P. Figueiredo A.A.M. Silva H. Bettiol R.F.L. Batista L.C. Coimbra Z.C. Lamy M.A. Barbieri |
| author_sort | V.S. Ribeiro |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T18:07:07Z |
| format | Article |
| id | doaj.art-f1c7605e743f492cbf14405d638f339b |
| institution | Directory Open Access Journal |
| issn | 1414-431X |
| language | English |
| last_indexed | 2024-12-19T18:07:07Z |
| publisher | Associação Brasileira de Divulgação Científica |
| record_format | Article |
| series | Brazilian Journal of Medical and Biological Research |
| spelling | doaj.art-f1c7605e743f492cbf14405d638f339b2022-12-21T20:11:25ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research1414-431X4091211122010.1590/S0100-879X2006005000130S0100-879X2007000900008Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?V.S. Ribeiro0F.P. Figueiredo1A.A.M. Silva2H. Bettiol3R.F.L. Batista4L.C. Coimbra5Z.C. Lamy6M.A. Barbieri7Universidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade de São PauloUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade Federal do MaranhãoUniversidade de São PauloThe 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008&lng=en&tlng=enCesarean sectionEpidemiologyObstetricsHealth servicesRisk factors |
| spellingShingle | V.S. Ribeiro F.P. Figueiredo A.A.M. Silva H. Bettiol R.F.L. Batista L.C. Coimbra Z.C. Lamy M.A. Barbieri Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? Brazilian Journal of Medical and Biological Research Cesarean section Epidemiology Obstetrics Health services Risk factors |
| title | Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? |
| title_full | Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? |
| title_fullStr | Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? |
| title_full_unstemmed | Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? |
| title_short | Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones? |
| title_sort | why are the rates of cesarean section in brazil higher in more developed cities than in less developed ones |
| topic | Cesarean section Epidemiology Obstetrics Health services Risk factors |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008&lng=en&tlng=en |
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