Cesarean delivery among nulliparous women in Beirut: Assessing predictors in nine hospitals

Tamim, H; el-Chemaly, SY; Nassar, AH; Aaraj, AM; Campbell, OMK; Kaddour, AA; Yunis, KA; (2007) Cesarean delivery among nulliparous women in Beirut: Assessing predictors in nine hospitals. Birth (Berkeley, Calif), 34 (1). pp. 14-20. ISSN 0730-7659 DOI: https://doi.org/10.1111/j.1523-536X.2006.00141.x

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Background: Obstetric practice has witnessed a worldwide trend of increasing cesarean section rates in recent years. Similar trends have been observed in Lebanon, according to 2 studies conducted in 1996 and 1999. The objective of the present study was to assess the differences in predictors of cesarean delivery among nulliparous women in a "control hospital" with a low cesarean delivery, rate (12.5%) and the rest of the National Collaborative Perinatal Neonatal Network (NCPNN). study hospitals" with a higher cesarean delivery rate (31.4%). Methods: Data were collected by the NCPNN database, which covers deliveries at 9 major hospitals located in the Greater Beirut area. Data analysis was performed on the 6,668 consecutive deliveries occurring between January 1, 2001, and December 31, 2002, at the NCPNN participating centers. The questionnaires included items that cover parental sociodentographic characteristics and maternal and newborn health characteristics. Sources of data included direct interviews with mothers after delivery and bi lore hospital discharge and reviews of obstetric and nursery medical charts. Chi-square tests and t tests were performed for categorical and continuous clinical predictors of cesarean section. Logistic regression was performed to determine the odds of having a cesarean section for the study hospitals when compared with the control hospital. Odds ratios and 95% confidence intervals are reported. Results: Variables in the study, hospitals that correlated with a higher cesarean delivery rate were male obstetricians, day of the week, and mode of payment compared with the control hospital. Conclusions: In a country with a high cesarean section rate, I hospital met World Health Organization criteria for acceptable cesarean section rates, with no compromise in neonatal outcome. Further studies are needed to investigate potential policies to decrease the high cesarean section rate.

Item Type: Article
Keywords: cesarean delivery, nulliparous women, predictors, Beirut, ADVANCED MATERNAL AGE, SECTION RATES, OUTCOMES, BIRTH, Adult, Cesarean Section, statistics & numerical data, Chi-Square Distribution, Confidence Intervals, Female, Hospitals, Urban, Humans, Infant, Newborn, Labor, Induced, statistics & numerical data, Lebanon, epidemiology, Logistic Models, Medical Records, statistics & numerical data, Odds Ratio, Parity, Pregnancy, Pregnancy Outcome, epidemiology, Questionnaires, Socioeconomic Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 17324173
Web of Science ID: 244527100004
URI: http://researchonline.lshtm.ac.uk/id/eprint/9531


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