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

Detalhes bibliográficos
Autor(a) principal: Ribeiro,V.S.
Data de Publicação: 2007
Outros Autores: Figueiredo,F.P., Silva,A.A.M., Bettiol,H., Batista,R.F.L., Coimbra,L.C., Lamy,Z.C., Barbieri,M.A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Medical and Biological Research
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008
Resumo: 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.
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spelling Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?Cesarean sectionEpidemiologyObstetricsHealth servicesRisk factorsThe 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.Associação Brasileira de Divulgação Científica2007-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008Brazilian Journal of Medical and Biological Research v.40 n.9 2007reponame:Brazilian Journal of Medical and Biological Researchinstname:Associação Brasileira de Divulgação Científica (ABDC)instacron:ABDC10.1590/S0100-879X2006005000130info:eu-repo/semantics/openAccessRibeiro,V.S.Figueiredo,F.P.Silva,A.A.M.Bettiol,H.Batista,R.F.L.Coimbra,L.C.Lamy,Z.C.Barbieri,M.A.eng2008-03-04T00:00:00Zoai:scielo:S0100-879X2007000900008Revistahttps://www.bjournal.org/https://old.scielo.br/oai/scielo-oai.phpbjournal@terra.com.br||bjournal@terra.com.br1414-431X0100-879Xopendoar:2008-03-04T00:00Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)false
dc.title.none.fl_str_mv Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?
title Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?
spellingShingle Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?
Ribeiro,V.S.
Cesarean section
Epidemiology
Obstetrics
Health services
Risk factors
title_short 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_sort Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?
author Ribeiro,V.S.
author_facet Ribeiro,V.S.
Figueiredo,F.P.
Silva,A.A.M.
Bettiol,H.
Batista,R.F.L.
Coimbra,L.C.
Lamy,Z.C.
Barbieri,M.A.
author_role author
author2 Figueiredo,F.P.
Silva,A.A.M.
Bettiol,H.
Batista,R.F.L.
Coimbra,L.C.
Lamy,Z.C.
Barbieri,M.A.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Ribeiro,V.S.
Figueiredo,F.P.
Silva,A.A.M.
Bettiol,H.
Batista,R.F.L.
Coimbra,L.C.
Lamy,Z.C.
Barbieri,M.A.
dc.subject.por.fl_str_mv Cesarean section
Epidemiology
Obstetrics
Health services
Risk factors
topic Cesarean section
Epidemiology
Obstetrics
Health services
Risk factors
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.
publishDate 2007
dc.date.none.fl_str_mv 2007-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000900008
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0100-879X2006005000130
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
dc.source.none.fl_str_mv Brazilian Journal of Medical and Biological Research v.40 n.9 2007
reponame:Brazilian Journal of Medical and Biological Research
instname:Associação Brasileira de Divulgação Científica (ABDC)
instacron:ABDC
instname_str Associação Brasileira de Divulgação Científica (ABDC)
instacron_str ABDC
institution ABDC
reponame_str Brazilian Journal of Medical and Biological Research
collection Brazilian Journal of Medical and Biological Research
repository.name.fl_str_mv Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)
repository.mail.fl_str_mv bjournal@terra.com.br||bjournal@terra.com.br
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