Factors associated to Caesarean delivery in public and private health care systems

• Autor(a) principal: Oliveira, Rosana Rosseto de
• Data de Publicação: 2016
• Outros Autores: Melo, Emiliana Cristina, Novaes, Elisiane Soares, Ferracioli, Patrícia Louise Rodrigues Varela, Mathias, Thais Aidar de Freitas
• Tipo de documento: Artigo
• Idioma: eng; por
• Título da fonte: Revista da Escola de Enfermagem da USP (Online)
• Texto Completo: https://www.revistas.usp.br/reeusp/article/view/147750
• topic: Cesarean Section; Risk Factors; Maternal and Child Health; Maternal-Child Nursing; Healthcare Financing; Cesárea; Fatores de Risco; Saúde Materno-Infantil; Enfermagem Materno-Infantil; Financiamento da Assistência à Saúde; Cesárea; Factores de Riesgo; Salud Materno-Infantil; Enfermería Maternoinfantil; Financiación de la Atención de la Salud

OBJECTIVE Identifying factors associated to Caesarean sections among the residents of Maringá-PR, according to the financing source for delivery. METHODS A cross-sectional study with data from 920 postpartum women interviewed between October 2013 and February 2014. Association analysis was performed by logistic regression. RESULTS Caesarean section rates were 55.5% in the Unified Healthcare System (SUS) and 93.8% in the private system. Factors associated with Caesarean section in the SUS were: previous Caesarean section (OR=8.9; CI=4.6-16.9), desire for Caesarean section early in pregnancy (OR=2.0; CI=1.1-3.6), pregestational overweight/obesity (OR=1.8; CI=1.1-2.8), and per capita family income higher than one minimum wage (OR=2.1; CI=1.3-3.4). In the private system, desire for Caesarean section early in pregnancy (OR=25.3) and a previous Caesarean section (OR=11.3) were strongly associated to its performance. CONCLUSION It is necessary to properly orientate all pregnant women who desire a Caesarean delivery, from both the SUS and the private system, about the inherent risks of the surgical procedure without indication. In the public health sector, guidelines should be focused on pregnant women with previous Caesarean delivery, with a per capita income higher than one minimum wage and those who are overweight or obese, as these women are more likely to have a Caesarean section.