Cesarean delivery on maternal request in southeast China

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• The past decade has seen a significant rise in cesarean delivery rates globally.
• Understanding regional variations and contributing factors is crucial for public health initiatives.

Purpose of the Study:

• To quantify the incidence of overall cesarean delivery and cesarean delivery on maternal request in southeast China.
• To analyze trends and identify associated factors over a 13-year period.

Main Methods:

• Utilized data from a population-based maternal and child health surveillance system covering 1.1 million singleton births (1994-2006).
• Defined cesarean delivery on maternal request as a prelabor cesarean in uncomplicated singleton gestations at ≥38 weeks.
• Analyzed changes in rates and associated risk factors over time.

Main Results:

• Overall cesarean rates escalated from 22% in 1994 to 56% in 2006, peaking at 60% in 2003.
• Cesarean delivery on maternal request rose from 0.8% to 20% during the study period.
• Rates varied significantly across different regions, with maternal education and parity being key factors.

Conclusions:

• Cesarean delivery on maternal request was the main contributor to the dramatic increase in cesarean rates in southeast China.
• The study highlights the need for targeted interventions to address the rising cesarean delivery rates and their underlying causes.