Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital

Detalhes bibliográficos
Autor(a) principal: Barbara Almeida Soares Dias
Data de Publicação: 2022
Outros Autores: Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064
Resumo: This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.
id FIOCRUZ-5_bc77c093446d6c2e2d9fe64dc38941bf
oai_identifier_str oai:ojs.teste-cadernos.ensp.fiocruz.br:article/8064
network_acronym_str FIOCRUZ-5
network_name_str Cadernos de Saúde Pública
repository_id_str
spelling Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospitalVariações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospitalCesarean SectionVaginal Birth After CesareanMaternal and Child HealthHealth SystemsCesáreaNascimento Vaginal Após CesáreaSaúde Materno-InfantilSistemas de SaúdeThis study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.El objetivo de este estudio fue describir las tasas de cesárea y de cesárea recurrente en Brasil según la edad gestacional (EG) al nacer y el tipo de hospital. Estudio ecológico a partir de los datos del Sistema de Información de Nacidos Vivos y del Registro Nacional de Establecimientos de Salud 2017. Se calcularon y analizaron las tasas de cesárea general y recurrente según EG, región de residencia y tipo de hospital. Se aplicaron las correlaciones de Spearman entre las tasas de cesárea y de cesárea recurrente por subgrupos de EG al nacer (≤ 33, 34-36, 37-38, 39-41 y ≥ 42 semanas) y se analizaron según el tipo de hospital. Las tasas de cesárea general y recurrente fueron del 55,1% y 85,3%, respectivamente. Más del 60% de los recién nacidos entre 37-38 semanas nacieron por cesárea. Los hospitales privados de todas las regiones concentraron las tasas más altas de cesáreas, especialmente los del Centro-Oeste, con más del 80% en todas las EG. En general, la tasa general de cesáreas estuvo altamente correlacionada con todas las tasas de cesáreas de los subgrupos de EG (r > 0,7, p < 0,01). En cuanto a la cesárea recurrente, se encontró que la tasa general se correlacionó fuertemente con las tasas de 37-38 y 39-41 semanas en el hospital público/mixto, a diferencia del hospital privado que mostró correlaciones moderadas. Esto indica que la decisión de hacer la cesárea no se basa en factores clínicos, lo que puede causar daños innecesarios a la salud de la mujer y del bebé. Por lo tanto, los cambios en el modelo de asistencia al parto, el fortalecimiento de las políticas públicas y una mayor promoción del parto vaginal en los embarazos posteriores de la cesárea se encuentran entre las estrategias importantes para reducir esta práctica en Brasil.O objetivo deste estudo foi descrever as taxas de cesariana e cesariana recorrente no Brasil segundo a idade gestacional (IG) ao nascer e o tipo de hospital. Trata-se de um estudo ecológico, utilizando dados do Sistema de Informação sobre Nascidos Vivos e do Cadastro Nacional de Estabelecimentos de Saúde de 2017. As taxas de cesariana geral e recorrente foram calculadas e analisadas de acordo com a IG, região de residência e tipo de hospital. Foram realizadas correlações de Spearman entre as taxas de cesariana e cesariana recorrente por subgrupos de IG ao nascer (≤ 33, 34-36, 37-38, 39-41 e ≥ 42 semanas), analisadas segundo o tipo de hospital. Verificaram-se taxas de cesariana geral e recorrente de 55,1% e 85,3%, respectivamente. Mais de 60% dos recém-nascidos entre 37-38 semanas ocorreram via cesariana. Os hospitais privados de todas as regiões concentraram as maiores taxas de cesariana, sobretudo os do Centro-oeste, com mais de 80% em todas as IG. A taxa geral de cesariana foi altamente correlacionada com todas as taxas de cesariana dos subgrupos de IG (r > 0,7, p < 0,01). Quanto à cesariana recorrente, verificou-se forte correlação com as taxas de 37-38 e 39-41 semanas no hospital público/misto, diferindo do hospital privado, que apresentou correlações moderadas. Isso indica que a decisão pela cesariana não é pautada em fatores clínicos, o que pode causar danos desnecessários à saúde da mulher e do bebê. Conclui-se que mudanças no modelo de atenção ao parto, fortalecimento de políticas públicas e maior incentivo do parto vaginal após cesárea em gestações subsequentes são estratégias importantes para a redução das cesarianas no Brasil.Reports in Public HealthCadernos de Saúde Pública2022-07-15info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064Reports in Public Health; Vol. 38 No. 6 (2022): JuneCadernos de Saúde Pública; v. 38 n. 6 (2022): Junho1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18072https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18073https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18074https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18075Barbara Almeida Soares DiasMaria do Carmo LealAna Paula Esteves-PereiraMarcos Nakamura-Pereirainfo:eu-repo/semantics/openAccess2024-03-06T15:30:20Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8064Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:15.049613Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
Variações das taxas de cesariana e cesariana recorrente no Brasil segundo idade gestacional ao nascer e tipo de hospital
title Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
spellingShingle Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
Barbara Almeida Soares Dias
Cesarean Section
Vaginal Birth After Cesarean
Maternal and Child Health
Health Systems
Cesárea
Nascimento Vaginal Após Cesárea
Saúde Materno-Infantil
Sistemas de Saúde
title_short Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
title_full Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
title_fullStr Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
title_full_unstemmed Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
title_sort Variations in cesarean and repeated cesarean section rates in Brazil according to gestational age at birth and type of hospital
author Barbara Almeida Soares Dias
author_facet Barbara Almeida Soares Dias
Maria do Carmo Leal
Ana Paula Esteves-Pereira
Marcos Nakamura-Pereira
author_role author
author2 Maria do Carmo Leal
Ana Paula Esteves-Pereira
Marcos Nakamura-Pereira
author2_role author
author
author
dc.contributor.author.fl_str_mv Barbara Almeida Soares Dias
Maria do Carmo Leal
Ana Paula Esteves-Pereira
Marcos Nakamura-Pereira
dc.subject.por.fl_str_mv Cesarean Section
Vaginal Birth After Cesarean
Maternal and Child Health
Health Systems
Cesárea
Nascimento Vaginal Após Cesárea
Saúde Materno-Infantil
Sistemas de Saúde
topic Cesarean Section
Vaginal Birth After Cesarean
Maternal and Child Health
Health Systems
Cesárea
Nascimento Vaginal Após Cesárea
Saúde Materno-Infantil
Sistemas de Saúde
description This study aimed to describe cesarean and repeated cesarean section rates in Brazil according to gestational age (GA) at birth and type of hospital. This is an ecologic study using data from the Brazilian Information System on Live Births and the 2017 National Registry of Health Facilities. Overall and repeated cesarean section rates were calculated and analyzed according to GA, region of residence, and type of hospital. Spearman correlations were performed between cesarean and repeated cesarean section rates by GA subgroups at birth (≤ 33, 34-36, 37-38, 39-41, and ≥ 42 weeks) and analyzed according to the type of hospital. Overall and repeated cesarean section rates were 55.1% and 85.3%, respectively. More than 60% of newborns between 37-38 weeks were delivered via cesarean section. Private hospitals in all regions showed the highest cesarean section rates, especially those in the Central-West Region, with more than 80% at all GAs. The overall cesarean section rate was highly correlated with all cesarean section rates of GA subgroups (r > 0.7, p < 0.01). Regarding repeated cesarean sections, the overall rate was strongly correlated with the rates of 37-38 and 39-41 weeks in public/mixed hospitals, differing from private hospitals, which showed moderate correlations. This finding indicates the decision for cesarean section is not based on clinical factors, which can cause unnecessary damage to the health of both the mother and the baby. Then, changes in the delivery care model, strengthening public policies, and encouragement of vaginal delivery after a cesarean section in subsequent pregnancies are important strategies to reduce cesarean section rates in Brazil.
publishDate 2022
dc.date.none.fl_str_mv 2022-07-15
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18072
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18073
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18074
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8064/18075
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
text/html
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 38 No. 6 (2022): June
Cadernos de Saúde Pública; v. 38 n. 6 (2022): Junho
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
_version_ 1798943397337104384

Registros relacionados