Risk factors associated with cesarean section in a Chinese rural population: a cross sectional study

To identify individual and clinical risk factors associated with cesarean section (CS) delivery in a Chinese rural population.

A cross-sectional study was conducted with data from hospital medical records in Henan Province and Anhui Province, China, using univariate and multiple logistic regression analyses.

Between January 1 and December 31, 2008, 46.3% (4,823/10,425) of deliveries were via CS in the study population. After adjustment for other variables, pregnant women in the 25-29-year-old (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.24-1.61) and > or = 30-year-old (OR 1.73, 95% CI 1.46-2.04) age groups were more likely to give birth by CS as compared to the 20-24-year-old age group. Other independent factors related to a higher risk of CS included nonagricultural occupation (OR 1.44, 95% CI 1.27-1.62), gestational hypertension (OR 5.22, 95% CI 3.93-6.93), breech presentation (OR 10.47, 95% CI 6.37-17.20), dystocia (OR 28.62, 95% CI 24.62-33.28), and preterm delivery (OR 1.28, 95% CI 1.06-1.54).

Age, occupation, gestational hypertension, breech presentation, and dystocia may play an important role in the high level of CS among women in a Chinese rural population. Further comprehensive studies on both medical and nonmedical reasons for CS delivery are needed.