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Robson 10-groups classification system to access C-section in two public hospitals of the Federal District/Brazil
Cláudia Vicari Bolognani1,2, Lílian Barros de Sousa Moreira Reis2, Adriano Dias2
1Medical School Coordination, Graduate School of Health Sciences/FEPECS/SES, Brasília, Federal District, Brazil.
Insights
Cesarean section rates in Brazil are high. This study evaluated C-section rates using the 10-Group Robson System, identifying high-risk groups like primigravida and previous C-section patients to guide reduction strategies.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Maternal-Fetal Medicine
Background:
- Global cesarean section (C-section) rates are increasing.
- In Brazil, C-section rates reach 58.94% in the Midwest region and 52.77% in the Federal District.
Purpose of the Study:
- To evaluate C-section rates in two public hospitals in Brazil's Federal District.
- To identify patient groups at highest risk for C-section using the 10-Group Robson System.
Main Methods:
- A cross-sectional study analyzed 6579 births at two hospitals (HA and HB) in 2013.
- C-section rates were compared between hospitals using proportion difference tests and logistic regression.
- The 10-Group Robson System classified births to assess C-section contributions.
Main Results:
- Overall C-section rates were 50.8% at HA and 42.3% at HB.
- Robson groups G5 (multiparous, previous C-section), G1 (nulliparous, single cephalic), and G2 (multiparous, single cephalic) showed the highest rates.
- Specific groups had significantly different C-section rates between the two hospitals (p < 0.05).
Conclusions:
- Findings highlight specific targets for reducing C-section rates in both hospitals.
- Interventions should focus on primigravida (G1) and patients with prior C-sections (G5).
Background:
The global increase in C-section rates is real. In Brazil, these indices correspond to 58.94% in the Midwest region and 52.77% in the Federal District.
Objective:
To evaluate the C-section rates and identify the groups with the greatest risk at two reference hospitals in the public network of Federal District/Brazil, using 10-Group Robson System.
Method:
A cross-sectional study of 6579 births assisted at the Hospital A (HA) and the Hospital B (HB) during 2013. The C-section rates in each group and its respective contribution to the total hospital C-sections was compared between HA and HB. To this, was used the proportion difference test (similar to chi-square test), with RR and 95% CI, and the logistic regression analysis (OR; 95% CI) among the groups with higher C-section/total C-section. The significance limit of p < 0.05 was defined for all tests.
Results:
The C-section rates were 50.8% at the HA and 42.3% at the HB, with 1.20 RR (95%CI = 1.13-1.28) at the HA. The highest rates were observed in Robson groups G5, G1, and G2. At the HA, G1 had a 21.5% C-section rate, which was greater than at the HB (13.8%; p < 0.05); the cesarean rates for groups G2 and G5 were higher at the HB (respectively, 18.6 and 38.1%) than at the HA (14.8 and 32.5%, respectively; p < 0.05).
Conclusion:
These results point out specific goals to be achieved in order to reduce abusive cesarean rates in both A and B hospitals, especially in the primigravida and in those with previous C-section.
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