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Caesarean section in the world: a new ecological approach
A Zizza1, A Tinelli, A Malvasi
1Institute of Clinical Physiology, IFC-CNR, National Council of Research, Lecce, Italy. zizza@ifc.cnr.it
Journal of Preventive Medicine and Hygiene
|March 27, 2012
Summary
Global caesarean section (CS) rates are high, particularly in developed regions. While CS rates often inversely correlate with maternal and neonatal mortality, identifying sensitive outcome indicators is crucial for evaluating the impact of increasing CS rates.
Area of Science:
- Global Health
- Obstetrics
- Demography
Background:
- Caesarean section (CS) rates vary globally.
- Understanding these rates and their relationship with healthcare indicators is essential.
Purpose of the Study:
- To estimate current global caesarean section rates.
- To examine associations between CS rates and healthcare indicators.
Main Methods:
- Analysis of CS rates across geo-economic and income groups.
- Correlation with maternal mortality, neonatal mortality, skilled birth attendance, and adolescent births.
- Statistical analysis using ANCOVA and piecewise regressions.
Main Results:
- Nearly half of countries exceed a 15% CS rate, with highest rates in Latin America, the Caribbean, Europe, North America, and Oceania.
- An inverse association between CS rates and maternal/neonatal mortality was observed globally, except in Europe.
- The association was strongest in lower-middle-income countries; high adolescent birth rates correlated with low CS use.
Conclusions:
- Identifying sensitive outcome indicators is necessary to evaluate the consequences of rising caesarean section rates.
- Further research is needed to understand the complex relationship between CS rates and maternal/neonatal health outcomes.
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