Examining Cesarean Delivery Rates Using the Robson's Ten-group Classification.

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Maternal-Fetal Medicine

Background:

• Cesarean delivery rates have shown a significant increase globally.
• The Robson's Ten-group classification system (TGCS) is a standardized method for auditing cesarean sections.
• Understanding cesarean delivery trends is crucial for improving maternal and neonatal outcomes.

Purpose of the Study:

• To analyze cesarean delivery rates over a decade using the Robson's Ten-group classification system.
• To identify key demographic and clinical groups contributing to the overall cesarean section rate.
• To provide data for targeted interventions aimed at optimizing cesarean delivery practices.

Main Methods:

• A retrospective analysis of all deliveries (vaginal and cesarean) from 2004 to 2013.
• Data were categorized annually according to the Robson's TGCS.
• Risk Ratios (RRs) and 95% confidence intervals were calculated for cesarean delivery within each Robson's group.

Main Results:

• The overall cesarean section rate (CSR) was 25.17% across 40,086 deliveries.
• Robson's groups 1 and 3 constituted 60% of the obstetric population.
• Groups 1 (37.62%) and 5 (17.06%) were the largest contributors to the total CSR; Groups 2 and 4 had high individual CSRs (47.28% and 34.74%).
• Maternal age and presentation independently correlated with the mode of delivery.

Conclusions:

• The TGCS effectively identified major contributor groups to the overall cesarean section rate.
• Focusing on the first four TGCS groups, representing approximately 75% of deliveries, is recommended for monitoring.
• Low-risk groups may harbor inappropriate cesarean section indications, necessitating closer examination.