Caesarean section trends in Catalonia between 2013 and 2017 based on the Robson classification system : A cross-sectional study
Carrillo-Aguirre, Garazi (Agència de Qualitat i Avaluació Sanitàries de Catalunya)
Dalmau-Bueno, Albert (Agència de Qualitat i Avaluació Sanitàries de Catalunya)
Campillo-Artero, Carlos (Universitat Pompeu Fabra)
García-Altés, Anna (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	In Catalonia caesarean rates have always been analysed as a single percentage. The objective is to estimate caesarean section rates using the Robson classification in publicly funded hospitals in Catalonia between 2013 and 2017, considering sociodemographic, institutional and obstetric characteristics. Cross-sectional population-based study in Catalonia including all women delivering within publicly funded hospitals between 2013-2017 (n = 210 020). The modified Robson classification distribution was estimated, the caesarean rate and the overall contribution, analysed for each year, and by confounders, through logistic regression models. CS rates decreased steadily between 2013 and 2017 in Catalonia within publicly funded hospitals from 24. 3% to 22. 8% (cOR 0. 92, 95% CI; 0. 89 to 0. 95). Once adjusted for changes in sociodemographic, institutional and obstetric characteristics the observed decline was even more pronounced (aOR 0. 87, 95% CI; 0. 84 to 0. 90). Within the different groups of Robson once adjusted for confounders, groups 1+2 (aOR 0. 88, 95% CI; 0. 83 to 0. 93), 3+4 (aOR 0. 83, 95% CI; 0. 78 to 0. 89) and 10 (aOR 0. 78, 95% CI; 0. 68 to 0. 90) presented a reduction in caesarean section rates, whereas group 5 showed no significant decrease (aOR 0. 95, 95% CI; 0. 87 to 1. 03%). The decrease in caesarean section rates in Catalonia is more pronounced when adjusted for known confounders, suggesting retrospective overutilization of caesarean section and percentages of (in)adequacy in the past. In any case, it remains above the recommended by experts. Further efforts should be made to achieve optimum rates, including improvement on obstetric data collection.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PloS one, Vol. 15 Núm. 6 (june 2020) , p. e0234727, ISSN 1932-6203

DOI: 10.1371/journal.pone.0234727
PMID: 32544171

17 p, 1.0 MB

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