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Stabilising the caesarean rate: which target population?

C Le Ray1, B Blondel, C Prunet

  • 1Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, INSERM UMR1153, Paris, France; Maternité Port-Royal, Department of Obstetrics and Gynaecology, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; DHU Risk in pregnancy, Paris, France.

BJOG : an International Journal of Obstetrics and Gynaecology
|November 22, 2014
PubMed
Summary

French caesarean rates rose until 2003, then stabilized. Between 2003-2010, increases in nulliparous women and those with prior caesareans drove the slight rise, highlighting areas for intervention.

Keywords:
Caesarean sectionFranceRobson classification

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Epidemiology

Background:

  • The caesarean section (CS) rate in France increased significantly between 1995 and 2003.
  • Following this increase, the CS rate remained relatively stable between 2003 and 2010.

Purpose of the Study:

  • To analyze the trends in caesarean rates in France from 1995 to 2010.
  • To identify specific demographic and clinical groups of women contributing to the rise and stabilization of caesarean rates.

Main Methods:

  • A cross-sectional, population-based study utilizing data from French national perinatal surveys.
  • Analysis included representative samples of women delivering in 1995, 2003, and 2010.
  • The Robson classification system was employed to categorize women based on pregnancy and delivery characteristics.

Main Results:

  • Overall caesarean rates were 15.4% (1995), 19.7% (2003), and 20.5% (2010).
  • Between 1995 and 2003, most maternal groups contributed to the rising CS rate.
  • From 2003 to 2010, CS rates stabilized or decreased in most groups, with increases attributed to nulliparous women (spontaneous and induced labor) and women with previous caesareans.

Conclusions:

  • Interventions focused on improving labor management in nulliparous women are crucial.
  • Such interventions may help stabilize overall caesarean rates and mitigate future increases, particularly among multiparous women.