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Caesarean Section in Peru: Analysis of Trends Using the Robson Classification System
Vilma Tapia1, Ana Pilar Betran2, Gustavo F Gonzales1,3
1Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru.
Plos One
|February 4, 2016
Summary
Cesarean section rates in Peru increased significantly from 2000-2010, driven by spontaneous labor and previous uterine scars. Women in Robson groups 1 and 3 faced higher maternal and perinatal complication risks.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Perinatal Epidemiology
Background:
- Global Cesarean section (CS) rates are rising, necessitating standardized monitoring systems.
- The Robson classification aids in understanding CS trends and identifying at-risk populations.
- Country-specific factors influence CS rates, requiring regional analysis.
Purpose of the Study:
- To analyze Cesarean section (CS) levels and trends in Peru using the Robson classification.
- To identify specific women's groups with the highest CS rates.
- To assess maternal and perinatal outcomes associated with CS rates across Robson groups.
Main Methods:
- Analysis of 549,681 deliveries from 43 Peruvian facilities (2000-2010).
- Application of the Robson classification to categorize women into ten groups.
- Statistical analysis including Cochran-Armitage test for trends and logistic regression for risk assessment.
Main Results:
- Overall CS rate increased from 23.5% to 30% between 2000 and 2010 (p<0.001).
- Increased CS rates observed in Robson groups 1, 3, 5, and 7.
- Robson groups 1 and 3 were significantly associated with stillbirths and maternal mortality.
Conclusions:
- Cesarean section rates rose due to increased CS in spontaneous labor and among women with scarred uteruses.
- Women in Robson groups 1 and 3 experienced higher maternal and perinatal complications.
- Previous Cesarean section is a key determinant of overall CS rates; Robson classification is valuable for monitoring in low-HDI countries.
