Tertiary hospital staff and caesarean section risk

A matched case-control study was conducted to determine whether pregnant employees of a Nigerian teaching hospital are more at risk of caesarean than vaginal delivery. Cases (n = 167) were booked patients who had singleton emergency caesarean delivery in their last confinement at term while controls (n = 167) were similar patients who had vaginal delivery (spontaneous or assisted) during the same period. Cases and controls were matched for known clinical risk factors for caesarean section. The proportion of hospital staff members among the cases was 36/167 (21.6%), compared with 21/167 (12.6%) among the controls, a difference that reached statistical significance (p = 0.03). Matched analysis examining the association of place of work with caesarean delivery indicated that hospital staff members are almost twice at risk of caesarean section than vaginal delivery (Mantel-Haenszel OR: 1.83; CI: 1.08 - 3.85). Multivariate conditional logistic regression analysis examining the association of hospital personnel with caesarean delivery while controlling for potential confounding variables revealed an adjusted odds ratio of 1.79 (CI: 1.02 - 3.74). Appraisal of caesarean section rate in teaching hospitals in southwest Nigeria could benefit from critical evaluation of the risk of caesarean section among parturients who are members of staff.