Factors associated with cesarean section rates in a university hospital

Detalhes bibliográficos
Autor(a) principal: Sakae, Thiago Mamôru
Data de Publicação: 2009
Outros Autores: Freitas, Paulo Fontoura, d'Orsi, Eleonora
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/32623
Resumo: OBJECTIVE: To assess factors associated to cesarean section. METHODS: A cross-sectional study was conducted in a university hospital in Florianópolis, Southern Brazil, from 2001 to 2005. Socioeconomic, reproductive, obstetric and institutional information were collected. Data from 7,249 deliveries was obtained from medical records and admission, delivery and post-delivery records. Cox regression was used in the analysis to estimate cesarean prevalence ratios in the categories of variables studied. RESULTS: Cesarean rates increased from 27.5% to 36.5% during the period studied and they were higher than those associated with medical indications. After adjustment for confounders cesarean rates were positively associated with previous cesarean section (PR=2.65, 95% CI: 2.31;3.05), non-cephalic presentation (PR=2.23, 95%CI: 1.69;2.95), oxytocin use (PR=1.77, 95%CI: 1.43;2.19), dilatation at admission (PR=2.74, 95%CI: 2.18;3.44), and obstetrician profile (>;35% of cesarean sections) (PR=1.82, 95%CI: 1.36;2.42). CONCLUSIONS: The factors associated with cesarean section indicate the need of interventions focusing on women and their reproductive experience and changes in obstetrician practice as well.
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spelling Factors associated with cesarean section rates in a university hospital Factores asociados a tasas de cesárea en hospital universitario Fatores associados a taxas de cesárea em hospital universitário Mujeres EmbarazadasCesáreaFactores de RiesgoFactores SocioeconómicosAtención PrenatalHospitales UniversitariosAnálisis MultivariantePregnant WomenCesarean SectionRisk FactorsSocioeconomic FactorsPrenatal CareHospitalsUniversityMultivariate AnalysisGestantesCesáreaFatores de RiscoFatores SocioeconômicosCuidado Pré-NatalHospitais UniversitáriosAnálise Multivariada OBJECTIVE: To assess factors associated to cesarean section. METHODS: A cross-sectional study was conducted in a university hospital in Florianópolis, Southern Brazil, from 2001 to 2005. Socioeconomic, reproductive, obstetric and institutional information were collected. Data from 7,249 deliveries was obtained from medical records and admission, delivery and post-delivery records. Cox regression was used in the analysis to estimate cesarean prevalence ratios in the categories of variables studied. RESULTS: Cesarean rates increased from 27.5% to 36.5% during the period studied and they were higher than those associated with medical indications. After adjustment for confounders cesarean rates were positively associated with previous cesarean section (PR=2.65, 95% CI: 2.31;3.05), non-cephalic presentation (PR=2.23, 95%CI: 1.69;2.95), oxytocin use (PR=1.77, 95%CI: 1.43;2.19), dilatation at admission (PR=2.74, 95%CI: 2.18;3.44), and obstetrician profile (>;35% of cesarean sections) (PR=1.82, 95%CI: 1.36;2.42). CONCLUSIONS: The factors associated with cesarean section indicate the need of interventions focusing on women and their reproductive experience and changes in obstetrician practice as well. OBJETIVO: Analizar factores asociados a la realización del parto cesariano. MÉTODOS: Estudio transversal realizado en hospital universitario de Florianópolis, Sur de Brasil, de 2001 a 2005. Fueron analizados factores socioeconómicos, de experiencias reproductivas, institucionales y relacionados con la práctica obstétrica. Las informaciones relativas a 7.249 partos fueron obtenidas a partir de prontuarios clínicos y registros de admisión, parto y post-parto. Fue utilizada la regresión de Cox en el análisis para estimar razones de prevalencia de cesárea en las categorías de las variables de interés. RESULTADOS: Las tasas de cesárea aumentaron de 27,5% a 36,5% en el período y estuvieron encima de aquellas debidas a indicaciones médicas. Posterior al ajuste para confundimento, las tasas de cesárea se mostraron positivamente asociadas con cesárea previa (RP=2,65; IC 95%: 2,31; 3,05), presentación no cefálica (RP=2,23; IC 95%: 1,69; 2,95), uso de ocitocina (RP=1,77; IC 95%: 1,43; 2,19), dilatación al ser admitida (RP=2,74; IC 95%: 2,18; 3,44), y obstetra con tasa de cesárea superior a 35% (RP=1,82; IC 95%: 1,36; 2,42). CONCLUSIONES: Los factores asociados a mayor probabilidad de cesárea mostraron la importancia de intervenciones direccionadas a la mujer y su experiencia reproductiva, así como cambios en la práctica obstétrica. OBJETIVO: Analisar fatores associados à realização do parto cesariano. MÉTODOS: Estudo transversal realizado em hospital universitário de Florianópolis (SC), de 2001 a 2005. Foram analisados fatores socioeconômicos, de experiências reprodutivas, institucionais e relacionados à prática obstétrica. As informações relativas a 7.249 partos foram obtidas a partir de prontuários clínicos e registros de admissão, parto e pós-parto. Foi utilizada a regressão de Cox na análise para estimar razões de prevalência de cesárea nas categorias das variáveis de interesse. RESULTADOS: As taxas de cesárea aumentaram de 27,5% a 36,5% no período e estiveram acima daquelas devidas a indicações médicas. Após ajuste para confundimento, as taxas de cesárea se mostraram positivamente associadas com cesárea prévia (RP=2,65; IC 95%: 2,31; 3,05), apresentação não-cefálica (RP=2,23; IC 95%: 1,69; 2,95), uso de ocitocina (RP=1,77; IC 95%: 1,43; 2,19), dilatação à admissão (RP=2,74; IC 95%: 2,18; 3,44), e obstetra com taxa de cesárea superior a 35%(RP=1,82; IC 95%: 1,36; 2,42). CONCLUSÕES: Os fatores associados a maior probabilidade de cesárea mostraram a importância de intervenções direcionadas à mulher e sua experiência reprodutiva, assim como mudanças na prática obstétrica. Universidade de São Paulo. Faculdade de Saúde Pública2009-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3262310.1590/S0034-89102009000300011Revista de Saúde Pública; Vol. 43 No. 3 (2009); 472-480 Revista de Saúde Pública; Vol. 43 Núm. 3 (2009); 472-480 Revista de Saúde Pública; v. 43 n. 3 (2009); 472-480 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/32623/34993Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessSakae, Thiago MamôruFreitas, Paulo Fontourad'Orsi, Eleonora2012-07-09T02:00:59Zoai:revistas.usp.br:article/32623Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-09T02:00:59Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Factors associated with cesarean section rates in a university hospital
Factores asociados a tasas de cesárea en hospital universitario
Fatores associados a taxas de cesárea em hospital universitário
title Factors associated with cesarean section rates in a university hospital
spellingShingle Factors associated with cesarean section rates in a university hospital
Sakae, Thiago Mamôru
Mujeres Embarazadas
Cesárea
Factores de Riesgo
Factores Socioeconómicos
Atención Prenatal
Hospitales Universitarios
Análisis Multivariante
Pregnant Women
Cesarean Section
Risk Factors
Socioeconomic Factors
Prenatal Care
Hospitals
University
Multivariate Analysis
Gestantes
Cesárea
Fatores de Risco
Fatores Socioeconômicos
Cuidado Pré-Natal
Hospitais Universitários
Análise Multivariada
title_short Factors associated with cesarean section rates in a university hospital
title_full Factors associated with cesarean section rates in a university hospital
title_fullStr Factors associated with cesarean section rates in a university hospital
title_full_unstemmed Factors associated with cesarean section rates in a university hospital
title_sort Factors associated with cesarean section rates in a university hospital
author Sakae, Thiago Mamôru
author_facet Sakae, Thiago Mamôru
Freitas, Paulo Fontoura
d'Orsi, Eleonora
author_role author
author2 Freitas, Paulo Fontoura
d'Orsi, Eleonora
author2_role author
author
dc.contributor.author.fl_str_mv Sakae, Thiago Mamôru
Freitas, Paulo Fontoura
d'Orsi, Eleonora
dc.subject.por.fl_str_mv Mujeres Embarazadas
Cesárea
Factores de Riesgo
Factores Socioeconómicos
Atención Prenatal
Hospitales Universitarios
Análisis Multivariante
Pregnant Women
Cesarean Section
Risk Factors
Socioeconomic Factors
Prenatal Care
Hospitals
University
Multivariate Analysis
Gestantes
Cesárea
Fatores de Risco
Fatores Socioeconômicos
Cuidado Pré-Natal
Hospitais Universitários
Análise Multivariada
topic Mujeres Embarazadas
Cesárea
Factores de Riesgo
Factores Socioeconómicos
Atención Prenatal
Hospitales Universitarios
Análisis Multivariante
Pregnant Women
Cesarean Section
Risk Factors
Socioeconomic Factors
Prenatal Care
Hospitals
University
Multivariate Analysis
Gestantes
Cesárea
Fatores de Risco
Fatores Socioeconômicos
Cuidado Pré-Natal
Hospitais Universitários
Análise Multivariada
description OBJECTIVE: To assess factors associated to cesarean section. METHODS: A cross-sectional study was conducted in a university hospital in Florianópolis, Southern Brazil, from 2001 to 2005. Socioeconomic, reproductive, obstetric and institutional information were collected. Data from 7,249 deliveries was obtained from medical records and admission, delivery and post-delivery records. Cox regression was used in the analysis to estimate cesarean prevalence ratios in the categories of variables studied. RESULTS: Cesarean rates increased from 27.5% to 36.5% during the period studied and they were higher than those associated with medical indications. After adjustment for confounders cesarean rates were positively associated with previous cesarean section (PR=2.65, 95% CI: 2.31;3.05), non-cephalic presentation (PR=2.23, 95%CI: 1.69;2.95), oxytocin use (PR=1.77, 95%CI: 1.43;2.19), dilatation at admission (PR=2.74, 95%CI: 2.18;3.44), and obstetrician profile (>;35% of cesarean sections) (PR=1.82, 95%CI: 1.36;2.42). CONCLUSIONS: The factors associated with cesarean section indicate the need of interventions focusing on women and their reproductive experience and changes in obstetrician practice as well.
publishDate 2009
dc.date.none.fl_str_mv 2009-06-01
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://www.revistas.usp.br/rsp/article/view/32623
10.1590/S0034-89102009000300011
url https://www.revistas.usp.br/rsp/article/view/32623
identifier_str_mv 10.1590/S0034-89102009000300011
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/32623/34993
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 43 No. 3 (2009); 472-480
Revista de Saúde Pública; Vol. 43 Núm. 3 (2009); 472-480
Revista de Saúde Pública; v. 43 n. 3 (2009); 472-480
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
_version_ 1800221789437034496

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